THE NATURAL HISTORY OF PATIENTS WITH ACUTE DISC HERNIATION: A SERIES OF 150 CASES

Autor: TELMO AUGUSTO BARBA BELSUZARRI, ENRICO AFFONSO BARLETTA, AUGUSTO RICARDO BARBA URENA, DANIEL DE ARAÚJO PAZ, FABIO VEIGA DE CASTRO SPARAPANI, FRANZ JOOJI ONISHI, SERGIO CAVALHEIRO, THIAGO SALATI, VINICIUS DE MELDAU BENITES, ANDREI FERNANDES JOAQUIM, EDUARDO AUGUSTO IUNES
Jazyk: English<br />Spanish; Castilian<br />Portuguese
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Zdroj: Coluna/Columna, Vol 19, Iss 2, Pp 116-119
Druh dokumentu: article
ISSN: 1808-1851
2177-014X
DOI: 10.1590/s1808-185120201902224169
Popis: ABSTRACT Objective This study aims to analyze the characteristics of patients with acute lumbar/sciatic disc herniation who underwent conservative, pain block procedures and surgical treatment, in order to better understand the natural history of herniations and their surgical indications, as well as the impact of hernia volume. Methods We analyzed 150 patients with a diagnosis of acute lumbar disc herniation. The treatments considered were: conservative, infiltration/pain block procedures and microdiscectomy. For seven patients who were surgically treated, the lumbar sequestrectomy volume was submitted to pathological analysis. Results Of the 150 patients, 80% were treated conservatively; 15.31% were treated with pain block procedures and 4.66% underwent microdiscectomy. The mean age of the surgical group was 42.5 years, and 57.1% of the patients were men. Most of the hernias were at L5-S1 (55.5%), and 77.7% were on the left side. All patients had presented significant lumbar pain or sciatica for a long period prior to the surgery. The Lasègue sign was present in all patients. Of the total number of patients, 85.7% presented hypoesthesia and 42.8% presented focal motor deficits, among other findings. The mean hernia volume was 9.6 cm3. Conclusions Unresponsiveness to conservative treatment is an important indication for surgery. The clinical manifestations in patients with a lumbar/sciatic hernia can be very diverse, as can the disc herniation volume, so these are not good indicators for surgery. Level of evidence IV; Case series
Databáze: Directory of Open Access Journals
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