Nykvist F, Hurme M, Alaranta H, Kaitsaari M.
Research and Development Centre of the Social Insurance Institution,
Turku, Finland.
This study involved 342 patients hospitalized because of severe,
persistent sciatica suggestive of a lumbar intervertebral disc herniation.
After standard clinical evaluation, EMG and myelography, 220 patients
underwent lumbar discectomy. The remaining 122 patients were treated
conservatively. Follow-up examinations were arranged after 1, 5
and 13 years. The study focused on the rehabilitation outcome in
general and differences in outcome between the two treatment groups.
Several indicators showed a rather poor outcome for sciatica patients
during the 13-year follow-up period. In the operated group 16% had
been re-operated because of lumbar disc herniation. True recurrence
of herniation (same level and side) occurred in 8%. In the conservatively
treated group 14% had undergone spinal surgery. Nearly 70% of the
patients still reported sciatica. Self-assessed levels of low back
pain were "no change/worse" for 19% in the operated group and for
44% in the conservatively treated group. In both the study groups,
nearly 40% of the subjects had retired on disability pensions.
In
a 70kg male subject intradiscal pressure in L3 lumbar disc is appoximately
comparable to his weight whilst standing erect.
686 Newtons (69 kg of force)
Unsupported
sitting can increase disc pressure by 40%
980Newtons (98kg of force)
In
a 70kg male subject intradiscal pressure in L3 lumbar disc is appoximately
comparable to his weight whilst standing erect.
686 Newtons (69 kg of force)
Even
bent leg lifting produces high pressures:
2058 Newtons (206kg of force)
PMID: 11161156 [PubMed - in process]
PMID: 8983651 [PubMed - indexed for MEDLINE] Image - DiscPressure.jpg
