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      Perception of Quality of Life at Patients after Surgery of Disc Herniation (Original research paper)

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      Clinical Social Work and Health Intervention

      Journal of Clinical Social Work and Health Intervention

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          Health related quality of life after lumbar disc surgery: a prospective study of 145 patients.

          This study compared health related quality of life (HRQOL) among lumber disc surgery patients to general population, and assessed the relationships between HRQOL and other outcome measures 2 and 14 months after surgery. The 15D instrument was use to measure HRQOL in 145 lumber disk surgery patients. Subjective outcome was also assessed by the Oswestry index, Short Depression Inventory (SDI) and pain, and objective outcome by trunk muscle strength and mobility of the spine. The mean (SD) 15D score among the patients 2 months after surgery was 0.880 (0.104) compared to 0.941 (0.076) among general population (p = 0.016). The 15D, Oswestry and SDI scores remained unchanged during the follow-up, while the improvements in the spine mobility and trunk muscle strength were significant. Back pain decreased by 68% and leg pain by 74% from preoperative level to 2 months check-up. Leg pain further decreased during the following 12 months, while back pain remained unchanged. HRQOL was associated with age, pain, Oswestry and SDI indices, but not with physical function. HRQOL measured by 15D was lower in lumber disc surgery patients compared to general population. 15D was associated with the subjective outcome measures of pain, Oswestry and SDI indices, but not with the objective measures of physical function. Thus, a combination of "disease specific" and "generic" measures is recommended to be used to obtain more accurate information about the overall welfare of individual.
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            Quality of life assessment before and after lumbar disc surgery.

            Although operative treatment for lumbar disc herniation is a commonly performed neurosurgical procedure, no reports have described whether health-related quality of life before surgery affects the operative treatment outcome. This prospective study assessed health-related quality of life before and after surgery and evaluated the predictor variables affecting outcomes. Subjects were 45 consecutive candidates for lumbar disc herniation surgery who gave informed consent. The Medical Outcomes Study Short Form 36 (SF-36) and 15-point Japanese Orthopaedic Association (JOA) score were evaluated before and after surgery, and the magnitude of the effect was calculated. The possible predictor variables for outcomes were physical functioning, role physical, bodily pain, general health, vitality, social functioning; role emotional and mental health from the SF-36 subscales; subjective symptoms and clinical signs from the JOA scores; and the patient's age, sex, occupation, and history of low back pain and/or leg pain. Four patients were excluded from the analyses because they were lost to follow-up within 1 year after operation. All subscales of the SF-36 and JOA scores increased significantly at 6 months and 1 year of follow-up with a maximum effect size in bodily pain and a minimal in general health. Operation results were 29 good, 11 fair, and 1 poor. The selected predictor variables affecting the outcomes were patient age and social functioning on SF-36. Surgery for lumbar disc herniation improved health-related quality of life. Patients <50 years old with a <60 score in social functioning on SF-36 were considered good candidates.
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              Health-related quality of life in patients after lumbar disc surgery: a longitudinal observational study.

              Objectives of this study are (1) to compare health-related quality of life (HRQOL) of patients after lumbar disc surgery with reference data from the German general population; (2) to examine whether changes in HRQOL occur over time; (3) to investigate associations between HRQOL and socio-demographic and health-related factors. The study sample consisted at baseline of 189 patients who underwent lumbar disc surgery. Baseline assessment was carried out 1-4 days after surgery, the first follow-up 2 months, the second follow-up 6 months after surgery. HRQOL was assessed by means of the WHOQOL-BREF. During follow-up, patients showed significant improvement in "physical well being" and "overall quality of life." However, it did not reach the level of the general population at any assessment point. There was also a slight improvement of "psychological well being." The domains "social relationships" and "environment" remained unchanged and showed persistently higher scores than the general population. Cohabitating was positively associated with QoL. Negatively associated were unemployment, part-time employment, desire for early retirement, higher intensity of pain and depression. Supplementing physical rehabilitation by psychosocial interventions may help improve patients' HRQOL.
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                Author and article information

                Journal
                Clinical Social Work and Health Intervention
                CSWHI
                Journal of Clinical Social Work and Health Intervention
                2222386X
                20769741
                October 20 2017
                October 20 2017
                : 8
                : 3
                : 43-48
                Article
                10.22359/cswhi_8_3_08
                © 2017

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