Does Site of Symptoms Influence the Surgical Results for Discogenic Low Back Pain Treatment?

Abstract

Introduction Surgical results for discogenic low back pain (DLBP) treatment remain controversial. The method of diagnosis of DLBP generally used is MRI and discography. However, this imaging sometime fails to diagnose DLBP. Symptoms from DLBP are varied and include back pain alone, referred leg pain, and referred inguinal pain. In the current study, we aimed to evaluate whether the site of symptoms influences surgical results for DLBP treatment. Materials and Methods The site of symptoms before surgery and the surgical result were retrospectively evaluated in 62 DLBP patients. Symptom sites before surgery were divided into (1) back pain alone, (2) back pain + referred inguinal pain, (3) back pain + referred thigh pain, and (4) back pain + referred lower leg pain. The patients showed disc degeneration only at one level (L4-5 or L5-S1) on MRI, pain provocation on discography, and underwent anterior interbody fusion. Visual analog scale (VAS) of back pain and the Roland-Morris disability questionnaire (RDQ) were evaluated before and 2 years after surgery. Results VAS and RDQ were not significantly different between the four groups before surgery, but were significantly improved in all four groups 2 years after surgery ( p < 0.05). The greatest improvement of back pain was found in the group with back pain + referred inguinal pain compared with the other three groups ( p < 0.05). Less improvement of back pain in the back pain alone group was seen compared with the back pain + referred thigh and back pain + referred lower leg pain groups ( p < 0.05). Conclusion If DLBP is strictly diagnosed using several imaging modes, surgical results were superior in patients with both back pain and either referred inguinal or leg pain compared with those having back pain alone. Disclosure of Interest None declared