ABSTRACT
BACKGROUND: It is presently unknown if lumbar lordosis (LL) might be applied to monitor low back pain (LBP) in patients with lumbar disc herniation (LDH). There is presently only conflicting data that does not show a correlation of LL with LBP: Previous studies do either include chronic LBP or do not consider that each patient has an individual value of LL that cannot be compared to other patients. METHODS: Power analysis: At least 32 patients had to be enrolled in the study. Out of 84 consecutive patients with acute onset of pain (<6 weeks) that were treated operatively from 11/2015 to 04/2017 by microscopic laminotomy for LDH, 35 were enrolled in this retrospective within - subject analysis after exclusion of patients with chronic LBP or severe disc degeneration of the lumbar spine. We recorded self - reported assessment of pain (VAS) and LL before the operation, 1 week and 6 weeks after the operation. We performed a paired - samples t - test (within - subject) to compare means of LL at admission to our institution with LL 6 weeks after surgery. Pearson's correlation was determined for LL and VAS. Significance level was set at p < 0.05. RESULTS: VAS at admission to our institution was 7.1 (0.4), VAS 6 weeks after surgery was 1.0 (0.3).LL at admission to our institution was 40.0 (2.1), LL 6 weeks after surgery was 48.0 (1.8). The difference was significant (p < 0.0005) with a high statistical power (1-ß = 0.99).Correlation of LL and VAS was significant (p < 0.01, r = -0.32). CONCLUSIONS: The increase of lumbar lordosis following surgery is significantly correlated to the decrease in the level of perceived pain in patients with a LDH and may be used as an additional tool to monitor the success of treatment in the investigated group of patients.
