Clinical and Functional Results of Patients with Surgically Treated Single Level Lumbar Disc Disease: Comparative Analysis of Patients with Disc Herniation, Stenosis of the Spinal Canal, and Lumbar Spondylolisthesis

Abstract

Introduction Degenerative lumbar disc disease may occur in patients in different ways, according to their etiopathogeny, for instance, disc herniation, stenosis of the canal, and spondylolisthesis. The objective will be to evaluate the results of health-related quality of life measures in patients with surgically treated single-level degenerative disc disease. Patients and Methods A prospective study of 141 patients with a single level disc disease who had a 1-year postoperative follow-up. The indications for surgical treatment were algic syndrome refractory to clinical treatment and compatibility among the symptoms, neurological examination, and magnetic resonance imaging. The patients were evaluated preoperatively and 30 days, 6 months, and 1-year postoperatively with instruments validated for the evaluation of axial and radicular pain, functional capacity, quality of life, mood disorders, and satisfaction with the surgical treatment. The statistical analyses were conducted using the SPSS. Results A total of 92 patients with lumbar disc herniation (LDH), 13 with spondylolisthesis, and 36 with lumbar canal stenosis (LCS) were evaluated. The patients with LDH were presented to microdiscectomy and the others to decompression and arthrodesis. Preoperatively, the LDH group presented lower levels of axial pain compared with the others; the mean radicular pain during this period was different among the groups, higher in patients with LDH, followed by the patients with canal stenosis. One year postoperatively, no differences were observed in the levels of axial and radicular pain among the groups, nor in the functional capacity, quality of life, and depression and anxiety. Preoperatively, a deficit of force, sensitivity, myotatic reflexes, and Lasègue sign were most commonly found in patients with LDH, compared with the other groups. There was no statistically significant difference as to changes in the neurological examination among the groups in 1 year of follow-up. Dissatisfaction with the treatment was observed in 12.0% of the patients with LDH, 15.4% with spondylolisthesis, and 20.0% with LCS ( p = 0.508). Conclusion In 1 year of follow-up, the indicators of quality of life, functional capacity, residual pain, and changes in the neurological examination are similar among the patients with level 1 disc disease treated surgically.