Predictive value of the duration of sciatica for lumbar discectomy. A prospective cohort study

J Bone Joint Surg Br. 2004 May;86(4):546-9.

Abstract

The optimum timing of lumbar discectomy for sciatica is imprecise. We have investigated a number of prognostic factors in relation to the outcome of radiculopathy after lumbar discectomy. We recruited 113 consecutive patients of whom 103 (91%) were followed up at one year. We found a significant association between the duration of radiculopathy and the changes in the Oswestry Disability Index score (p = 0.005) and the low back outcome score (p = 0.03). Improvement in pain was independent of all variables. Patients with an uncontained herniated disc had a shorter duration of symptoms and a better functional outcome than those with a contained herniation. Our study suggests that patients with sciatica for more than 12 months have a less favourable outcome. We detected no variation in the results for patients operated on in whom the duration of sciatica was less than 12 months.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Diskectomy*
  • Female
  • Follow-Up Studies
  • Humans
  • Intervertebral Disc Displacement / complications
  • Intervertebral Disc Displacement / surgery*
  • Lumbar Vertebrae / surgery*
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Prognosis
  • Prospective Studies
  • Sciatica / etiology
  • Sciatica / surgery*
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome