J Korean Neurosurg Soc.  2013 Sep;54(3):183-188. 10.3340/jkns.2013.54.3.183.

Surgical versus Conservative Treatment for Lumbar Disc Herniation with Motor Weakness

• Choi HS
• Kwak KW
• Kim SW
• Ahn SH

• KMID: 2190895
• DOI: http://doi.org/10.3340/jkns.2013.54.3.183

Abstract

OBJECTIVE
The aim of this study is to assess outcomes during first one year for patients with severe motor weakness caused by lumbar disc herniation that underwent surgical or nonsurgical treatment.
METHODS
The 46 patients with motor weakness because of lumbar disc herniation who were treated at neurosurgical department and rehabilitation in our hospital from 2006 to 2010, retrospectively. Each group had 26 surgical treatments and 20 conservative treatments. We followed up 1, 3, 6 months and 12 month and monitored a Visual Analogue rating Scale (VAS) of back and leg pain, Oswestry Disability Index (ODI) and degree of motor weakness. We analyzed the differences between surgical and nonsurgical groups using Mann-Whitney U test and repeat measure ANOVA in each follow-up periods.
RESULTS
In the recovery of motor weakness, surgical treatment uncovered a rapid functional recovery in the early periods (p=0.003) and no difference between groups at the end of follow-up period was found (p>0.05). In VAS of back and leg, the interaction between time and group was not found (p>0.05) and there was no difference between groups (p>0.05). In ODI, the interaction between time and group was not found (p>0.05) and there was no difference between groups (p>0.05).
CONCLUSION
Surgical treatment for motor weakness caused by herniated intervertebral disc resulted in a rapid recovery in the short-term period, especially 1 month. We think early and proper surgical treatment in a case of motor weakness from disc herniation could be a good way for providing a chance for rapid alleviation.

Keyword

Lumbar Region; Disc; Herniation; Surgery; Weakness

MeSH Terms

Follow-Up Studies
Humans
Intervertebral Disc
Leg
Lumbosacral Region
Retrospective Studies

Figure

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  Fig. 1 There is statistically significant interaction between time and group (p<0.05). The results reveal that a rapid motor recovery could be obtained with surgical treatment at the early stage of follow-up period, even though the degree of motor recovery at 12 months has no significant difference. MRC : Medical Research Cancil.

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  Fig. 2 There is no statistically significant interaction between time and groups in VAS score on back (p>0.05). VAS : Visual Analogue Rating Sale.

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  Fig. 3 There is no statistically significant interaction between time and groups in VAS score on leg (p>0.05). VAS : Visual Analogue Rating Sale.

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  Fig. 4 There is no statistically significant interaction between time and groups in ODI score on back (p>0.05). ODI : Oswestry Disability Index.

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