Clinical factors of importance for outcome after lumbar disc herniation surgery: long-term follow-up

Eur Spine J. 2010 Sep;19(9):1459-67. doi: 10.1007/s00586-010-1433-7. Epub 2010 May 29.


Factors as age, sex, smoking, duration of leg pain, working status, type/level of disc herniation and psychosocial factors have been demonstrated to be of importance for short-term results after lumbar discectomy. There are few studies with long-term follow-up. In this prospective study of lumbar disc herniation patients undergoing surgery, the result was evaluated at 2 and 5-10 (mean 7.3) years after surgery. Predictive factors for satisfaction with treatment and objective outcome were investigated. Out of the included 171 patients undergoing lumbar discectomy, 154 (90%) patients completed the 2-year follow-up and 140 (81%) completed the long-term follow-up. Baseline data and questionnaires about leg- and back pain intensity (VAS), duration of leg pain, disability (Oswestry Disability Index), depression (Zung Depression Scale), sick leave and employment status were obtained preoperatively, at 2-year- and long-term follow-up. Primary outcome included patient satisfaction with treatment (at both time points) and assessment of an independent observer at the 2-year follow-up. Secondary outcomes at 2-year follow-up were improvement of leg and back pain, working capacity and the need for analgesics or sleeping pills. In about 70% of the patients excellent or good overall result was reported at both follow-ups, with subjective outcome measurements. The objective evaluation after 2 years was in agreement with this result. Time on sick leave was found to be a clinically important predictor of the primary outcomes, with a potential of changing the probability of a satisfactory outcome (both objective and subjective) from around 50% (sick leave >3 months) to 80% (sick leave <2 months). Time on sick leave was also an important predictor for several of the secondary outcomes; e.g. working capacity and the need for analgesics.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Disability Evaluation*
  • Diskectomy
  • Female
  • Follow-Up Studies
  • Humans
  • Intervertebral Disc Displacement / surgery*
  • Lumbar Vertebrae / surgery*
  • Male
  • Pain Measurement
  • Patient Satisfaction
  • Recovery of Function*
  • Sick Leave / statistics & numerical data
  • Surveys and Questionnaires
  • Treatment Outcome