After two years of operation, the National Neurosurgery Quality and Outcomes Database was used in a study to examine the effectiveness of lumbar surgery for disc herniation, according to a report in Pain Medicine News.
The N2QOD registry provided 12-month surgical outcomes data on patients who underwent lumbar spine surgery for disc herniation. The study was then presented at the American Association of Neurological Surgeons annual meeting earlier this year. Here are five findings from the study:
1. The lumbar spine surgery was effective 86.2 percent of the patients studied after one year. The outcomes registry includes patients from 43 clinical sites. Anthony Asher, MD, FAANS, led the research team on this nationwide, prospective, longitudinal outcomes database measuring the safety and effectiveness of neurosurgical care.
2. There was improvement in all patient reported outcomes at three months and one year, according to the report. The data included 75 percent of the patients who were initially entered into the registry; only 25 percent were lost in follow-up.
A study commissioned by the American Academy of Orthopaedic Surgeons shows in 2010 people with back pain missed an average of 26 work days per year and spent around 34 days in bed. The study showed patients who underwent surgery received an average of nearly $2,000 more per year and missed three fewer days than those who underwent non-surgical care. Over four years, the people who underwent surgery averaged $7,000 per year more than the non-surgical patients, according to a report from A Nation in Motion.
3. The predictors for the same or worse Oswestry Disability Index score at 12 months among those who did not experience improvement were:
• Patient's education level
• Baseline ODI
• Liability claims
The researchers also found unique predictors for disc herniation were similar to what surgeons may anecdotally find are likely to predict outcomes, according to the report. The unique predictors included: age, symptom duration and depression.
4. However, there was great variability in outcomes at the individual patient level. "This variability has been observed at all participating centers, in all diagnoses and in all procedures included in the registry," said Dr. Asher in an AANS news release. "Making sense of the variability — specifically, determining the combined contribution of patient characteristics and other variables to specific clinical outcomes — will produce tremendous benefit for surgeons, their patients and other healthcare stakeholders."
5. Ultimately, the study authors concluded that lumbar surgery for disc herniation and spondylolisthesis is highly effective in a real-world setting, but a significant subset of patients do not report improved disability scores at 12 months after surgery.
The Spine Patient Outcomes Research Trial also examined whether surgery or conservative treatment was better for patients with disc herniation. After two years, the study found patients in both groups improved substantially with a tendency for the surgical group to do better, according to a Spine-health report. Additionally, 45 percent of the patients who were randomized into the no-surgery group switched to have surgery and 40 percent of the patients randomized into the surgery group declined the procedure.
More Articles on Spine Surgery:
Is Cervical Spine Surgery Cost-Effective? 5 Things to Know
What Drives Hospital Employment? 4 Spine Surgeons Weigh In
5 Findings on Lumbar Interbody Fusion Alignment