Abstract
Introduction
Lumbar disc herniation (LDH) is currently a prevalent pathology which leads to physical, psychological, and social limitations for the patient. The most frequent signs and symptoms are lumbocyatalgia, motor and sensitive disorders, and Lasègue sign. In patients with LDH refractory to medical treatment, discectomy is the standard procedure to improve the symptoms. The objective of this study is to study the prognostic relevance of signs and symptoms in patients with LDH refractory to medical treatment.
Materials and Methods
a systematic review was performed in the main biomedical databases, searching for articles that studied the percentage of improvement and prognostic value of the preoperative signs and symptoms of patients with LDH. The signs and symptoms evaluated were lumbar pain, leg pain, motor and sensitive disorders and Lasègue sign.
Results
Some authors found that the preoperative low back pain was a negative predictor of outcome after LDH surgery whereas others did not find a correlation with prognosis. The more intense the leg pain the better were the results as the duration of the symptoms was less than a mean time of 6 months. The sensitive deficit in the leg and Laségue sign were usually reported as positive prognostic factors. The different study designs and instruments to assess the outcome explained some disagreement observed in the literature.
Conclusion
The literature shows that the success rate in surgery of patients with LDH refractory to medical treatment is correlated with the absence of lumbalgia, the presence of cyatalgia over up to 6 months, the sensitive deficit present alone or associated with MD, and the presence of a positive Lasègue sign during the preoperative period.