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Favorable long-term health-related quality of life after surgery for lumbar disc herniation in young adult patients

BACKGROUND: Lumbar disc herniation is often managed conservatively; nevertheless, surgical intervention can be required. Majority of patients experience a drastic relief of symptoms after surgery, but previous studies have reported that their health-related quality of life remains inferior compared...

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Autores principales: Roiha, Miika, Marjamaa, Johan, Siironen, Jari, Koskinen, Seppo, Koski-Palkén, Anniina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Vienna 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10006264/
https://www.ncbi.nlm.nih.gov/pubmed/36805802
http://dx.doi.org/10.1007/s00701-023-05522-9
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author Roiha, Miika
Marjamaa, Johan
Siironen, Jari
Koskinen, Seppo
Koski-Palkén, Anniina
author_facet Roiha, Miika
Marjamaa, Johan
Siironen, Jari
Koskinen, Seppo
Koski-Palkén, Anniina
author_sort Roiha, Miika
collection PubMed
description BACKGROUND: Lumbar disc herniation is often managed conservatively; nevertheless, surgical intervention can be required. Majority of patients experience a drastic relief of symptoms after surgery, but previous studies have reported that their health-related quality of life remains inferior compared to the general population for several years. There may be a major cumulative loss of health-related quality of life for young patients as they have long expected life ahead of them. METHODS: A total of 526 eligible adult patients under the age of 40 underwent surgery for lumbar disc herniation from 1990 to 2005. Patients’ baseline characteristics were acquired by chart review to confirm eligibility to the study. Follow-up quality of life data was acquired by sending patients EQ-5D questionnaire at median 18 years after index surgery, and those 316 patients responding to the questionnaire (60%) were included in the study. Propensity score matching was utilized to match every study patient with two general population sample participants from a large Finnish population health study. Primary objective was to compare the quality of life to that of the control population. Secondary objective was to explore which patient characteristics lead to inferior outcome. RESULTS: The mean EQ-index for the patient cohort was 0.86, while it was 0.84 for the age and gender–matched general population sample (difference 0.02, 95% CI − 0.0004 to 0.049). Within the patient cohort, an increasing number of lifetime lumbar surgeries was associated with progressively deteriorating EQ-index scores (p = 0.049) and longer duration of symptoms prior to the surgery correlated with lower score (p = 0.013). CONCLUSION: Patients who underwent surgery for lumbar disc herniation nearly two decades ago reported quality of life comparable to the age and gender–matched general population. However, patients who had undergone numerous lumbar surgeries had significantly worse outcome. Therefore, possible ways to prevent cumulation of lumbar surgeries could improve long-term health-related quality of life.
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spelling pubmed-100062642023-03-12 Favorable long-term health-related quality of life after surgery for lumbar disc herniation in young adult patients Roiha, Miika Marjamaa, Johan Siironen, Jari Koskinen, Seppo Koski-Palkén, Anniina Acta Neurochir (Wien) Original Article - Spine degenerative BACKGROUND: Lumbar disc herniation is often managed conservatively; nevertheless, surgical intervention can be required. Majority of patients experience a drastic relief of symptoms after surgery, but previous studies have reported that their health-related quality of life remains inferior compared to the general population for several years. There may be a major cumulative loss of health-related quality of life for young patients as they have long expected life ahead of them. METHODS: A total of 526 eligible adult patients under the age of 40 underwent surgery for lumbar disc herniation from 1990 to 2005. Patients’ baseline characteristics were acquired by chart review to confirm eligibility to the study. Follow-up quality of life data was acquired by sending patients EQ-5D questionnaire at median 18 years after index surgery, and those 316 patients responding to the questionnaire (60%) were included in the study. Propensity score matching was utilized to match every study patient with two general population sample participants from a large Finnish population health study. Primary objective was to compare the quality of life to that of the control population. Secondary objective was to explore which patient characteristics lead to inferior outcome. RESULTS: The mean EQ-index for the patient cohort was 0.86, while it was 0.84 for the age and gender–matched general population sample (difference 0.02, 95% CI − 0.0004 to 0.049). Within the patient cohort, an increasing number of lifetime lumbar surgeries was associated with progressively deteriorating EQ-index scores (p = 0.049) and longer duration of symptoms prior to the surgery correlated with lower score (p = 0.013). CONCLUSION: Patients who underwent surgery for lumbar disc herniation nearly two decades ago reported quality of life comparable to the age and gender–matched general population. However, patients who had undergone numerous lumbar surgeries had significantly worse outcome. Therefore, possible ways to prevent cumulation of lumbar surgeries could improve long-term health-related quality of life. Springer Vienna 2023-02-19 2023 /pmc/articles/PMC10006264/ /pubmed/36805802 http://dx.doi.org/10.1007/s00701-023-05522-9 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article - Spine degenerative
Roiha, Miika
Marjamaa, Johan
Siironen, Jari
Koskinen, Seppo
Koski-Palkén, Anniina
Favorable long-term health-related quality of life after surgery for lumbar disc herniation in young adult patients
title Favorable long-term health-related quality of life after surgery for lumbar disc herniation in young adult patients
title_full Favorable long-term health-related quality of life after surgery for lumbar disc herniation in young adult patients
title_fullStr Favorable long-term health-related quality of life after surgery for lumbar disc herniation in young adult patients
title_full_unstemmed Favorable long-term health-related quality of life after surgery for lumbar disc herniation in young adult patients
title_short Favorable long-term health-related quality of life after surgery for lumbar disc herniation in young adult patients
title_sort favorable long-term health-related quality of life after surgery for lumbar disc herniation in young adult patients
topic Original Article - Spine degenerative
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10006264/
https://www.ncbi.nlm.nih.gov/pubmed/36805802
http://dx.doi.org/10.1007/s00701-023-05522-9
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