Predicting the Need for Surgery in Patients with Lumbar Disc Herniation: A New Internally Validated Scoring System Article Swipe
Rouzbeh Motiei-Langroudi
,
Homa Sadeghian
,
Uduak-Obong I. Ekanem
,
Aleeza Safdar
,
Andrew J. Grossbach
,
Stephanus Viljoen
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.31616/asj.2023.0023
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.31616/asj.2023.0023
Study Design: Prospective study.Purpose: To propose a scoring system for predicting the need for surgery in patients with lumbar disc herniation (LDH).Overview of Literature: The indications for surgery in patients with LDH are well established. However, the exact timing of surgery is not. According to surgeons, patients with failed conservative treatment who underwent delayed surgery, often after 6 months postsymptom initiation, have poor functional recovery and outcome.Methods: The current study included patients with symptomatic LDH. Patients with an indication for emergent surgery such as profound or progressive motor deficit, cauda equina syndrome, and diagnoses other than single-level LDH were excluded from the analysis. All patients followed a conservative treatment regimen (a combination of physical therapy, pain medications, and/or spinal epidural steroid injections). Surgery was indicated for patients who continuously experienced pain despite maximal conservative therapy.Results: In total, 134 patients met the inclusion and exclusion criteria. Among them, 108 (80.6%) responded to conservative management, and 26 (19.4%) underwent unilateral laminotomy and microdiscectomy. The symptom duration, disc degeneration grade on magnetic resonance imaging (Pfirrmann disc grade), herniated disc location and type, fragment size, and thecal sac diameter significantly differed between patients who responded to conservative treatment and those requiring surgery. The area under the receiver operating characteristic curve of the scoring system based on the anteroposterior size of the herniated disc fragment and herniated disc location and type was 0.81.Conclusions: A scoring system based on herniated disc/fragment size, location, and type can be applied to predict the need for surgery in patients with LDH. In the future, this tool can be used to prevent unnecessarily prolonged conservative management (>4–8 weeks).
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.31616/asj.2023.0023
- https://www.asianspinejournal.org/upload/pdf/asj-2023-0023.pdf
- OA Status
- diamond
- Cited By
- 3
- References
- 19
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4388572433
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4388572433Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.31616/asj.2023.0023Digital Object Identifier
- Title
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Predicting the Need for Surgery in Patients with Lumbar Disc Herniation: A New Internally Validated Scoring SystemWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2023Year of publication
- Publication date
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2023-11-10Full publication date if available
- Authors
-
Rouzbeh Motiei-Langroudi, Homa Sadeghian, Uduak-Obong I. Ekanem, Aleeza Safdar, Andrew J. Grossbach, Stephanus ViljoenList of authors in order
- Landing page
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https://doi.org/10.31616/asj.2023.0023Publisher landing page
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https://www.asianspinejournal.org/upload/pdf/asj-2023-0023.pdfDirect link to full text PDF
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YesWhether a free full text is available
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diamondOpen access status per OpenAlex
- OA URL
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https://www.asianspinejournal.org/upload/pdf/asj-2023-0023.pdfDirect OA link when available
- Concepts
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Medicine, Surgery, Disc herniation, Lumbar disc herniation, Conservative treatment, Low back pain, Magnetic resonance imaging, Lumbar, Regimen, Radiology, Alternative medicine, PathologyTop concepts (fields/topics) attached by OpenAlex
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3Total citation count in OpenAlex
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2025: 3Per-year citation counts (last 5 years)
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19Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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