Surgery versus Nerve Blocks for Lumbar Disc Herniation : Quantitative Analysis of Radiological Factors as a Predictor for Successful Outcomes

Joohyun Kim; Junseok W. Hur; Jang-Bo Lee; Jung Yul Park

doi:10.3340/jkns.2016.59.5.478

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Surgery versus Nerve Blocks for Lumbar Disc Herniation : Quantitative Analysis of Radiological Factors as a Predictor for Successful Outcomes

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Surgery versus Nerve Blocks for Lumbar Disc Herniation : Quantitative Analysis of Radiological Factors as a Predictor for Successful Outcomes

Joohyun Kim, Junseok W. Hur, Jang-Bo Lee and Jung Yul Park

Journal of Korean Neurosurgical Society, Vol.59(5), pp.478-484

09/01/2016

DOI: 10.3340/jkns.2016.59.5.478

PMCID: PMC5028608

PMID: 27651866

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Abstract

Objective : To assess the clinical and radiological factors as predictors for successful outcomes in lumbar disc herniation (LDH) treatment. Methods : Two groups of patients with single level LDH (L4-5) requiring treatment were retrospectively studied. The surgery group (SG) included 34 patients, and 30 patients who initially refused the surgery were included in the nerve blocks group (NG). A visual analogue scale (VAS) for leg and back pain and motor deficit were initially evaluated before procedures, and repeated at 1, 6, and 12 months. Radiological factors including the disc herniation length, disc herniation area, canal length-occupying ratio, and canal area-occupying ratio were measured and compared. Predicting factors of successful outcomes were determined with multivariate logistic regression analysis after the optimal cut off values were established with a receiver operating characteristic curve. Results : There was no significant demographic difference between two groups. A multivariate logistic regression analysis with radiological and clinical (12 months follow-up) data revealed that the high disc herniation length with cutoff value 6.31 mm [odds ratio (OR) 2.35; confidence interval (CI) 1.21-3.98] was a predictor of successful outcomes of leg pain relief in the SG. The low disc herniation length with cutoff value 6.23 mm (OR 0.05; CI 0.003-0.89) and high baseline VAS leg (OR 12.63; CI 1.64-97.45) were identified as predictors of successful outcomes of leg pain relief in the NG. Conclusion : The patients with the disc herniation length larger than 6.31 mm showed successful outcomes with surgery whereas the patients with the disc herniation length less than 6.23 mm showed successful outcomes with nerve block. These results could be considered as a radiological criteria in choosing optimal treatment options for LDH.

Surgery

Clinical Neurology

Life Sciences & Biomedicine

Neurosciences & Neurology

Science & Technology

Details

Title: Subtitle: Surgery versus Nerve Blocks for Lumbar Disc Herniation : Quantitative Analysis of Radiological Factors as a Predictor for Successful Outcomes
Creators: Joohyun Kim - Korea University
Junseok W. Hur - Korea University
Jang-Bo Lee - Korea University
Jung Yul Park - Korea Univ, Anam Hosp, Coll Med, Dept Neurosurg, 73 Inchon Ro, Seoul 02841, South Korea
Resource Type: Journal article
Publication Details: Journal of Korean Neurosurgical Society, Vol.59(5), pp.478-484
DOI: 10.3340/jkns.2016.59.5.478
PMID: 27651866
PMCID: PMC5028608
NLM abbreviation: J Korean Neurosurg Soc
ISSN: 2005-3711
eISSN: 1598-7876
Publisher: Korean Neurosurgical Soc
Number of pages: 7
Language: English
Date published: 09/01/2016
Academic Unit: Neurosurgery
Record Identifier: 9984459620802771

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