Recovery of muscle strength after microdiscectomy for lumbar disc herniation: a prospective cohort study with 1-year follow-up.

Abstract

Surgery has not been proven to be a better treatment option than non-operative management for limb paresis due to lumbar disc herniation. For the patients it will still be a concern, whether they will regain full strength after the operation or not. A prospective cohort study of 91 patients with preoperative paresis due to disc herniation with 1-year follow up was carried out. The primary outcome was muscle strength in affected limb, and the secondary outcome was self-reported symptoms on back and leg pain, disability, health related quality of life, general health and working capability. Seventy-five percent of patients had no paresis 1 year after the operation. The severity of the paresis was the only predictor for persistent paresis. Preoperative duration of the paresis did not influence the rate of full recovery. Non-recovery was associated with inferior outcomes and higher risk for reduced working capability. The majority of patients with paresis were fully recovered 1 year after microdiscectomy for lumbar disc herniation. If the paresis was severe at baseline, there was a four times higher risk for non-recovery. Patients who did not recover had significantly worse outcomes.