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Health-related quality of life in patients with surgically treated lumbar disc herniation: 2- and 7-year follow-up of 117 patients
University of Gothenburg, Sahlgrenska University Hospital, Department of Orthopaedics.
Gothenburg Spine Center.
Landspitali University Hospital, Reykjavik.
University of Gothenburg, Sahlgrenska University Hospital, Department of Orthopaedics.
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2011 (English)In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 82, no 2, p. 198-203Article in journal (Refereed) Published
Abstract [en]

Background and purpose: Health-related quality of life (HRQoL) instruments have been of increasing interest for evaluation of medical treatments over the past 10-15 years. In this prospective, long-term follow-up study we investigated the influence of preoperative factors and the change in HRQoL over time after lumbar disc herniation surgery. Methods: 117 patients surgically treated for lumbar disc herniation (L4-L5 or L5-S1) were evaluated with a self-completion HRQoL instrument (EQ-5D) preoperatively, after 2 years (96 patients) and after 7 years (89 patients). Baseline data (age, sex, duration of leg pain, surgical level) and degree of leg and back pain (VAS) were obtained preoperatively. The mean age was 39 (18-66) years, 54% were men, and the surgical level was L5-S1 in 58% of the patients. The change in EQ-5D score at the 2-year follow-up was analyzed by testing for correlation and by using a multiple regression model including all baseline factors (age, sex, duration of pain, degree of leg and back pain, and baseline EQ-5D score) as potential predictors. Results: 85% of the patients reported improvement in EQ-5D two years after surgery and this result remained at the long-term follow-up. The mean difference (change) between the preoperative EQ-5D score and the 2-year and 7-year scores was 0.59 (p < 0.001) and 0.62 (p < 0.001), respectively. However, the HRQoL for this patient group did not reach the mean level of previously reported values for a normal population of the same age range at any of the follow-ups. The changes in EQ-5D score between the 2- and 7-year follow-ups were not statistically significant (mean change 0.03, p = 0.2). There was a correlation between baseline leg pain and the change in EQ-5D at the 2-year (r = 0.33, p = 0.002) and 7-year follow-up (r = 0.23, p = 0.04). However, when using regression analysis the only statistically significant predictor for change in EQ-5D was baseline EQ-5D score. Interpretation: Our findings suggest that HRQoL (as measured by EQ-5D) improved 2 years after lumbar disc herniation surgery, but there was no further improvement after 5 more years. Low quality of life and severe leg pain at baseline are important predictors of improvement in quality of life after lumbar disc herniation surgery. © Nordic Orthopaedic Federation.

Place, publisher, year, edition, pages
2011. Vol. 82, no 2, p. 198-203
Keywords [en]
adult, aged, article, backache, controlled study, disease course, disease severity, EuroQol 5 Dimension, female, follow up, human, intermethod comparison, leg pain, lumbar disk hernia, major clinical study, male, outcome assessment, predictor variable, preoperative evaluation, prospective study, quality of life, questionnaire, scoring system, Short Form 36, spine surgery, surgical patient, visual analog scale, Adolescent, Follow-Up Studies, Humans, Intervertebral Disc Displacement, Lumbar Vertebrae, Middle Aged, Pain Measurement, Prospective Studies, Questionnaires, Treatment Outcome, Young Adult
National Category
Information Systems, Social aspects
Research subject
SOCIAL SCIENCE, Informatics
Identifiers
URN: urn:nbn:se:hv:diva-4510DOI: 10.3109/17453674.2011.566136OAI: oai:DiVA.org:hv-4510DiVA, id: diva2:542460
Available from: 2012-08-01 Created: 2012-08-01 Last updated: 2017-12-07Bibliographically approved

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