Prevalence of Long-term Low Back Pain After Symptomatic Lumbar Disc Herniation.

Overview

abstract

OBJECTIVE: Lumbar disc herniation (LDH) is a global issue associated with potentially debilitating long-term consequences, including chronic low back pain (LBP). Short-term outcomes (< 2 years) of LDH patients have been extensively studied and demonstrate improvements in back and leg pain for both operative and conservative management. However, these improvements may not be sustained long-term (>2 years); LDH patients may develop recurrent disc herniations, progressive degenerative disc disease, and LBP regardless of management strategy. Therefore, our objective is to determine the prevalence of chronic LBP after LDH, understand the relationship between LDH and chronic LBP, and investigate the relationship between radiological findings and postoperative pain outcomes. METHODS: We performed a literature review on the PubMed database via a combination medical subject heading and keyword-based approach for long-term LBP outcomes in LDH patients. RESULTS: 15 studies (2019 patients) evaluated surgical and/or nonoperative outcomes of LDH patients. Regardless of surgical or nonoperative management, 46.2% of LDH patients experienced some degree of LBP long-term (range 2-27 years) as compared to a point prevalence of LBP in the general population of only 11.9%. CONCLUSIONS: LDH patients are more likely to experience long-term LBP compared to the general population (46.2% vs. 11.9%). Additionally, understanding the relationship between radiological findings and pain outcomes remains a major challenge as the presence of radiological changes and the degree of LBP do not always correlate. Therefore, higher quality studies are needed to better understand the relationship between radiological findings and pain outcomes.