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SAT0420 Prognostic factors for non-success in patients with sciatica and disc herniation
  1. A.J. Haugen1,
  2. J.I. Brox2,
  3. L. Grøvle1,
  4. A. Keller3,
  5. B. Natvig4,5,
  6. D. Soldal6,
  7. M. Grotle4,7
  1. 1Department of Rheumatology, Østfold Hospital Trust, Fredrikstad
  2. 2Orthopaedic Department, Oslo University Hospital, Rikshospitalet
  3. 3Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ullevål
  4. 4National Resource Centre for Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital
  5. 5Department of General Practice and Community Medicine, ASAM, University of Oslo, Oslo
  6. 6Department of Rheumatology, Sørlandet Hospital Health Enterprise, Kristiansand
  7. 7FORMI (Communication Unit for Musculoskeletal Disorders), Division of Neuroscience, Oslo University Hospital, Ullevål, Oslo, Norway

Abstract

Background Few studies have investigated prognostic factors for patients with sciatica, especially for patients treated without surgery [1].

Objectives The aim of this study was to identify factors associated with non-success after 1 and 2 years of follow-up.

Methods The study was a prospective observational study from four hospitals in Norway including 466 patients with sciatica and lumbar disc herniation. Potential prognostic factors were sociodemographic characteristics, back pain history, kinesiophobia, emotional distress, pain, comorbid subjective health complaints and clinical examination findings. Study participation did not alter treatment considerations for the patients in the clinics. Patients reported on the questionnaires if surgery of the disc herniation had been performed. Uni- and multivariate logistic regression analyses were used to evaluate factors associated with non-success, defined as Maine–Seattle Back Questionnaire score of ≥5 (0–12) [2].

Results At 1 and 2 year follow-ups, the rates of non-success were 44% and 39%, respectively. Approximately 1/3 of the patients were treated surgically. In the final multivariate model, non-success at 1 year was significantly associated with being male (OR1.7 [95% CI; 1.1-2.7]), smoker (2.1 [1.3-3.3]), more back pain (1.0 [1.01-1.02]), more comorbid subjective health complaints (1.1 [1.0-1.2]), reduced tendon reflex (1.6 [1.01-1.02]), and not treated surgically (3.0 [1.8-5.0]). Further, factors significantly associated with non-success at 2 years were duration of back problems >1 year (1.9 [1.1-3.3]), duration of sciatica >3 months (2.3 [1.4-3.8]), more comorbid subjective health complaints (1.1 [1.0-1.1]) and kinesiophobia (1.04 [1.00-1.08]).

Conclusions The absence of surgical treatment during the observation period was associated with non-success at the 1-year follow-up, but not at the 2-year follow-up. Prognosis of sciatica was only weakly associated with sciatica-specific clinical findings, and more strongly associated with pain, comorbid subjective health complaints and kinesiophobia.

  1. Ashworth J, Konstantinou K, Dunn KM. Prognostic Factors in Non-Surgically Treated Sciatica: A Systematic Review. BMC Musculoskelet Disord 2011;12:208.

  2. Haugen AJ, Grovle L, Brox JI, Natvig B, Keller A, Soldal D, Grotle M. Estimates of success in patients with sciatica due to lumbar disc herniation depend upon outcome measure. Eur Spine J 2011;20:1669-1675.

Disclosure of Interest None Declared

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