Abstract
Introduction
The incidence of motor deficits (MD) varies from 15 to 69% during the investigative or preoperative period. There seems to be no consensus regarding the precise importance of neurological impairment in determining the need for surgery and its impact on the patient's self-reported health-related quality of life (HRQoL). The objective of this study was to evaluate the impact of MD on the HRQoL of patients with lumbar disc herniation (LDH) before a specific treatment.
Patients and Methods
A prospective cohort of 254 consecutively enrolled patients with LDH associated to neurological impairment and sciatica without a response to conservative treatment was evaluated. After exclusion criteria, 168 were included. Validated instruments in the preoperative period were used to evaluate QoL: pain, disability, QoL, anxiety, and depression.
Results
A normal motor strength was observed in 57 (33.9%) patients and MD was observed in 111 (66.1%) cases. No statistically significant differences were observed between patients with and without MD regarding gender, age, level of herniation, lateralization, and work compensation. Regarding QoL, no difference was detected in the eight domains of SF-36 and between the PCS and MCS groups. The only difference observed was a higher disability rate in the MD group, with the mean ODI difference being 7.84 (CI 95%, 1.82–13.87; p = 0.011) Motor weakness was observed by 35.1% (n = 39/111) of patients with an abnormal motor examination and it was related to severity (X2: 46.058; p < 0.0001).
Conclusion
In patients with LDH without a specific treatment, the presence of MD does not impair the pain, disability, depression, and self-reported QoL measures. The MD has no discriminative power for QoL measures in patients with LDH.