ABSTRACT
The object of this study was to introduce a new scoring system for the severity of lumbar disc that has a significant stratification of outcome between individual scores of patients, and in this way, it can help in selecting patients who will most likely benefit from surgical treatment. To identify potential factors in a risk prediction tool, we conducted a multivariate logistic regression analysis of patients-and lesion-specific factors suspected to be associated with outcome in a series of 383 patients with lumbar disc prolapse, of whom 160 patients were managed conservatively and 223 patients were managed surgically. Factors that were strongly associated with outcome were used to develop a comprehensive scoring system for the severity of lumbar disc prolapse. Our results showed that 10 factors were strongly associated with outcome; 4 factors in the patient's history, 3 in clinical examination and 3 in the finding of CT scan or MR imaging. In the system, one point was given for each of those 10 factors. By adding the total points, a 10-point scoring system was obtained. According to this scoring system, while the outcome was directly related to the preoperative score in the surgical group [r=0.63 and P> 0.001], it was inversely related to the preoperative score in the conservative group [r=0.59 and P<0.001]. Our results indicate that the prototype of our scoring system is easy to apply, highly predictive of outcome, and can be used as a guide for the usefulness of surgical intervention