PROGNOSTIC FACTORS OF LUMBAR DISCECTOMY RECOVERY.A PROSPECTIVE ANALYSIS

Brandão, Thiago Kolachinski; Machado, André Nunes; Moter, Bruno Vieira; Yonezaki, Adriano Masayuki; Ueno, Fabrício Hidetoshi; Rodrigues, Luciano Miller Reis

doi:10.1590/S1808-185120171604147556

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Original Article • Coluna/Columna 16 (04) • Oct-Dec 2017 • https://doi.org/10.1590/S1808-185120171604147556 copy

PROGNOSTIC FACTORS OF LUMBAR DISCECTOMY RECOVERY.A PROSPECTIVE ANALYSIS

FATORES PROGNÓSTICOS DA RECUPERAÇÃO DE DISCECTOMIA LOMBAR.UMA ANÁLISE PROSPECTIVA

FACTORES PRONÓSTICOS DE LA RECUPERACIÓN DE DISCECTOMÍA LUMBAR.UN ANÁLISIS PROSPECTIVO

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective: To perform a prospective analysis of the quality of life prognostic factors in patients undergoing lumbar discectomy after two years of the procedure, relating the tools Short Form Health Survey, Roland Morris, Oswestry Disability Index, and VAS. Methods: Seventy-two patients were evaluated through the questionnaires in the preoperative, and one month, six months, one year and two years in the postoperative period, being performed lumbar discectomy after failure of conservative treatment. Results: We observed an improvement in comparative analysis during follow-up regarding baseline values. Conclusion: The domains social aspect, pain, general state, emotional aspect, mental health and vitality presented an improvement from the first month after the surgery; however, the domain functional capacity only showed significant improvement after 6 months and the physical aspects only after one year. Roland-Morris and VAS scales improved after one month after surgery, but Oswestry scale showed that for the measured aspects there was only improvement after six months of surgery.

Keywords:
Intervertebral disc displacement; Prognosis; Quality of life; Surveys and questionnaires; Lumbosacral region.

		Count	Column N %
Decade of life	10 to 19 years	2	3%
	20 to 29 years	13	18%
	30 to 39 years	20	28%
	40 to 49 years	12	17%
	50 to 59 years	18	25%
	60 to 69 years	6	8%
	70 to 79 years	1	1%
Number of levels	1	64	89%
Number of levels	2	8	11%
Would undergo surgery again	Yes	60	83%
Would undergo surgery again	No	12	17%
Return to activities	Yes	36	50%
Return to activities	No	36	50%
Tobacco user	Yes	22	31%
Tobacco user	No	50	69%

	Median	25%	75%	Comparison with preoperative
sf36 pre social aspect	50	38	69	<0.0001
sf36 1M social aspect	63	63	88	<0.0001
sf36 6M social aspect	88	63	88	<0.0001
sf36 1Y social aspect	88	75	100	<0.0001
sf36 2Y social aspect	87.5	87.5	100
sf36 pre functional capacity	15	10	25
sf36 1M functional capacity	20	10	33	0.121
sf36 6M functional capacity	45	25	58	<0.0001
sf36 1Y functional capacity	50	40	65	<0.0001
sf36 2Y functional capacity	45	38	60	<0.0001
sf36 pre pain	30	20	40
sf36 1M pain	50	50	70	<0.0001
sf36 6M pain	60	50	70	<0.0001
sf36 1Y pain	70	60	80	<0.0001
sf36 2Y pain	70	60	80	<0.0001
sf36 pre general state of health	60	45	80
sf36 1M general state of health	63	50	80	0.006
sf36 6M general state of health	65	55	80	0.001
sf36 1Y general state of health	68	55	80	0.002
sf36 2Y general state of health	65	50	80	0.028
sf36 pre limitation by emotional aspect	66.66	33.33	100
sf36 1M limitation by emotional aspect	100	67	100	0.011
sf36 6M limitation by emotional aspect	100	100	100	0.050
sf36 1Y limitation by emotional aspect	100	100	100	0.011
sf36 2Y limitation by emotional aspect	100	100	100	0.014
sf36 pre limitation by physical aspect	25	25	25
sf36 1M limitation by physical aspect	25	25	75	0.414
sf36 6M limitation by physical aspect	50	25	50	0.084
sf36 1Y limitation by physical aspect	50	25	75	0.047
sf36 2Y limitation by physical aspect	50	38	75	0.011
sf36 pre mental health	54	42	62
sf36 1M mental health	68	62	76	<0.0001
sf36 6M mental health	76	60	80	<0.0001
sf36 1Y mental health	76	60	80	<0.0001
sf36 2Y mental health	72	64	80	<0.0001
sf36 pre vitality	50	35	60
sf36 1M vitality	65	60	70	<0.0001
sf36 6M vitality	68	60	70	<0.0001
sf36 1Y vitality	70	60	80	<0.0001
sf36 2Y vitality	75	68	80	<0.0001

	Median	25th Percentile	75th Percentile	Comparison with preoperative
Oswestry pre	59	43	68
Oswestry 1M	52	34	65	.206
Oswestry 6M	45	28	60	.034
Oswestry 1Y	40.0	22.5	55.0	.001
Oswestry 2Y	31	28	52	<0.001
Roland-Morris pre	19	15	20
Roland-Morris 1M	12	8	16	<0.001
Roland-Morris 6M	9	6	14	<0.001
Roland-Morris 1Y	7	5	13	<0.001
Roland-Morris 2Y	7	5	10	<0.001
VAS pre	9	8	10
VAS 1M	6	3	8	<0.001
VAS 6M	5	2	6	<0.001
VAS 1Y	4	2	6	<0.001
VAS 2Y	3	2	5	<0.001

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[1] Correspondence: Rua Júlio Verne, 129. Jardim Hípico. São Paulo, SP, Brazil. 04725-060 thiago.kb@terra.com.br