Does Size of a Disc Herniation Matter?

Does Size of a Disc Herniation Matter?

In this study, we examined whether the size of a lumbar disc herniation (LDH) is predictive of the need for surgical intervention within 2 years after obtaining an initial magnetic resonance imaging (MRI) scan.

A total of 336 patients did not undergo surgery within 1 year of the LDH diagnosis. 185 had L4-L5 herniations (50.3%), and 169 had L5-S1 herniations (45.9%) . Patients who did not receive surgery had an average herniation size that occupied 31.2% of the canal, whereas patients who received surgery had disc herniations that occupied 31.5% of the canal on average.

After controlling for age, race, gender, and location of herniation through a logistic regression, it was found that the size of the herniation and the percentage of the canal that was occupied had no predictive value with regard to failure of conservative management, generating an odds ratio for surgery of 1.00.

Conclusions: The percentage of the spinal canal occupied by a herniated disc does not predict which patients will fail nonoperative treatment and require surgery within 2 years after undergoing a lumbar spine MRI scan.

Reference: https://pubmed.ncbi.nlm.nih.gov/32905720/

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#discherniation #l4l5 #sciatica