Nonsurgical treatment outcomes for surgical candidates with lumbar disc herniation: a comprehensive cohort study

Abstract Physicians often encounter surgical candidates with lumbar disc herniation (LDH) who request non-surgical management even though surgery is recommended. However, second opinions may differ among doctors. Therefore, a prospective comprehensive cohort study (CCS) was designed to assess outcom...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Chi Heon Kim, Yunhee Choi, Chun Kee Chung, Ki-Jeong Kim, Dong Ah Shin, Youn-Kwan Park, Woo-Keun Kwon, Seung Heon Yang, Chang Hyun Lee, Sung Bae Park, Eun Sang Kim, Hyunsook Hong, Yongeun Cho
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8c317416e6514ea098d6151cea694928
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:8c317416e6514ea098d6151cea694928
record_format	dspace
spelling	oai:doaj.org-article:8c317416e6514ea098d6151cea6949282021-12-02T10:54:06ZNonsurgical treatment outcomes for surgical candidates with lumbar disc herniation: a comprehensive cohort study10.1038/s41598-021-83471-y2045-2322https://doaj.org/article/8c317416e6514ea098d6151cea6949282021-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-83471-yhttps://doaj.org/toc/2045-2322Abstract Physicians often encounter surgical candidates with lumbar disc herniation (LDH) who request non-surgical management even though surgery is recommended. However, second opinions may differ among doctors. Therefore, a prospective comprehensive cohort study (CCS) was designed to assess outcomes of nonsurgical treatment for surgical candidates who were recommended to undergo surgery for LDH but requested a second opinion. The CCS includes both randomized and observational cohorts, comprising a nonsurgery cohort and surgery cohort, in a parallel fashion. Crossover between the nonsurgery and surgery cohorts was allowed at any time. The present study was an as-treated interim analysis of 128 cases (nonsurgery cohort, n = 71; surgery cohort, n = 57). Patient-reported outcomes included visual analogue scores for the back (VAS-B) and leg (VAS-L), the Oswestry Disability Index, the EuroQol 5-Dimension instrument, and the 36-Item Short-Form Health Survey (SF-36), which were evaluated at baseline and at 1, 3, 6, 12, and 24 months. At baseline, age and SF-36 physical function were significantly lower in the surgery cohort than in the nonsurgery cohort (p < 0.05). All adjusted outcomes significantly improved after both nonsurgical and surgical treatment (p < 0.05). The nonsurgery cohort showed less improvement of VAS-B and VAS-L scores at 1 month (p < 0.01), but no difference between cohorts was observed thereafter for 24 months (p > 0.01). Nonsurgical management may be a negotiable option even for surgical candidates in the shared decision-making process.Chi Heon KimYunhee ChoiChun Kee ChungKi-Jeong KimDong Ah ShinYoun-Kwan ParkWoo-Keun KwonSeung Heon YangChang Hyun LeeSung Bae ParkEun Sang KimHyunsook HongYongeun ChoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Chi Heon Kim Yunhee Choi Chun Kee Chung Ki-Jeong Kim Dong Ah Shin Youn-Kwan Park Woo-Keun Kwon Seung Heon Yang Chang Hyun Lee Sung Bae Park Eun Sang Kim Hyunsook Hong Yongeun Cho Nonsurgical treatment outcomes for surgical candidates with lumbar disc herniation: a comprehensive cohort study
description	Abstract Physicians often encounter surgical candidates with lumbar disc herniation (LDH) who request non-surgical management even though surgery is recommended. However, second opinions may differ among doctors. Therefore, a prospective comprehensive cohort study (CCS) was designed to assess outcomes of nonsurgical treatment for surgical candidates who were recommended to undergo surgery for LDH but requested a second opinion. The CCS includes both randomized and observational cohorts, comprising a nonsurgery cohort and surgery cohort, in a parallel fashion. Crossover between the nonsurgery and surgery cohorts was allowed at any time. The present study was an as-treated interim analysis of 128 cases (nonsurgery cohort, n = 71; surgery cohort, n = 57). Patient-reported outcomes included visual analogue scores for the back (VAS-B) and leg (VAS-L), the Oswestry Disability Index, the EuroQol 5-Dimension instrument, and the 36-Item Short-Form Health Survey (SF-36), which were evaluated at baseline and at 1, 3, 6, 12, and 24 months. At baseline, age and SF-36 physical function were significantly lower in the surgery cohort than in the nonsurgery cohort (p < 0.05). All adjusted outcomes significantly improved after both nonsurgical and surgical treatment (p < 0.05). The nonsurgery cohort showed less improvement of VAS-B and VAS-L scores at 1 month (p < 0.01), but no difference between cohorts was observed thereafter for 24 months (p > 0.01). Nonsurgical management may be a negotiable option even for surgical candidates in the shared decision-making process.
format	article
author	Chi Heon Kim Yunhee Choi Chun Kee Chung Ki-Jeong Kim Dong Ah Shin Youn-Kwan Park Woo-Keun Kwon Seung Heon Yang Chang Hyun Lee Sung Bae Park Eun Sang Kim Hyunsook Hong Yongeun Cho
author_facet	Chi Heon Kim Yunhee Choi Chun Kee Chung Ki-Jeong Kim Dong Ah Shin Youn-Kwan Park Woo-Keun Kwon Seung Heon Yang Chang Hyun Lee Sung Bae Park Eun Sang Kim Hyunsook Hong Yongeun Cho
author_sort	Chi Heon Kim
title	Nonsurgical treatment outcomes for surgical candidates with lumbar disc herniation: a comprehensive cohort study
title_short	Nonsurgical treatment outcomes for surgical candidates with lumbar disc herniation: a comprehensive cohort study
title_full	Nonsurgical treatment outcomes for surgical candidates with lumbar disc herniation: a comprehensive cohort study
title_fullStr	Nonsurgical treatment outcomes for surgical candidates with lumbar disc herniation: a comprehensive cohort study
title_full_unstemmed	Nonsurgical treatment outcomes for surgical candidates with lumbar disc herniation: a comprehensive cohort study
title_sort	nonsurgical treatment outcomes for surgical candidates with lumbar disc herniation: a comprehensive cohort study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/8c317416e6514ea098d6151cea694928
work_keys_str_mv	AT chiheonkim nonsurgicaltreatmentoutcomesforsurgicalcandidateswithlumbardischerniationacomprehensivecohortstudy AT yunheechoi nonsurgicaltreatmentoutcomesforsurgicalcandidateswithlumbardischerniationacomprehensivecohortstudy AT chunkeechung nonsurgicaltreatmentoutcomesforsurgicalcandidateswithlumbardischerniationacomprehensivecohortstudy AT kijeongkim nonsurgicaltreatmentoutcomesforsurgicalcandidateswithlumbardischerniationacomprehensivecohortstudy AT dongahshin nonsurgicaltreatmentoutcomesforsurgicalcandidateswithlumbardischerniationacomprehensivecohortstudy AT younkwanpark nonsurgicaltreatmentoutcomesforsurgicalcandidateswithlumbardischerniationacomprehensivecohortstudy AT wookeunkwon nonsurgicaltreatmentoutcomesforsurgicalcandidateswithlumbardischerniationacomprehensivecohortstudy AT seungheonyang nonsurgicaltreatmentoutcomesforsurgicalcandidateswithlumbardischerniationacomprehensivecohortstudy AT changhyunlee nonsurgicaltreatmentoutcomesforsurgicalcandidateswithlumbardischerniationacomprehensivecohortstudy AT sungbaepark nonsurgicaltreatmentoutcomesforsurgicalcandidateswithlumbardischerniationacomprehensivecohortstudy AT eunsangkim nonsurgicaltreatmentoutcomesforsurgicalcandidateswithlumbardischerniationacomprehensivecohortstudy AT hyunsookhong nonsurgicaltreatmentoutcomesforsurgicalcandidateswithlumbardischerniationacomprehensivecohortstudy AT yongeuncho nonsurgicaltreatmentoutcomesforsurgicalcandidateswithlumbardischerniationacomprehensivecohortstudy
_version_	1718396480833716224

Nonsurgical treatment outcomes for surgical candidates with lumbar disc herniation: a comprehensive cohort study

Ejemplares similares