{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T14:31:08Z","timestamp":1777127468192,"version":"3.51.4"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Sciatica is the hallmark symptom of a lumbar disc herniation (LDH). Up to 90% of LDH patients recover within 12 weeks regardless of treatment. With continued deteriorating symptoms and low patient quality of life, most surgeons recommend surgical discectomy. However, there is not yet a clear consensus regarding the proper timing of surgery. The aim of this study was to evaluate how the duration of preoperative leg pain (sciatic neuralgia) is associated with patient-reported levels of postoperative leg pain reduction and other patient-reported outcome measures (PROMs) in a prospectively collected data set from a large national cohort.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>All patients aged 18\u201365 years undergoing a lumbar discectomy during 2013\u20132016 and registered in Swespine (the Swedish national spine registry) with 1 year of postoperative follow-up data were included in the study (n = 6216). The patients were stratified into 4 groups according to preoperative pain duration: &lt; 3, 3\u201312, 12\u201324, or &gt; 24 months. Patient results assessed with the numeric rating scale (NRS) for leg pain (rated from 0 to 10), global assessment of leg pain, EQ-5D, Oswestry Disability Index (ODI), and patient satisfaction with the final surgical outcome were analyzed and compared with preoperative values and between groups.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>A significant improvement was seen 1 year postoperatively regardless of preoperative pain duration (change in NRS score: mean \u22124.83, 95% CI \u22124.73 to \u22124.93 in the entire cohort). The largest decrease in leg pain NRS score (mean \u22125.59, 95% CI \u22125.85 to \u22125.33) was seen in the operated group with the shortest sciatica duration (&lt; 3 months). The patients with a leg pain duration in excess of 12 months had a significantly higher risk of having unchanged radiating leg pain 1 year postoperatively compared with those with &lt; 12-month leg pain duration at the time of surgery (OR 2.41, 95% CI 1.81\u20133.21, p &lt; 0.0001).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Patients with the shortest leg pain duration (&lt; 3 months) reported superior outcomes in all measured parameters. More significantly, using a 12-month pain duration as a cutoff, patients who had a lumbar discectomy with a preoperative symptom duration &lt; 12 months experienced a larger reduction in leg pain and were more satisfied with their surgical outcome and perception of postoperative leg pain than those with &gt; 12 months of sciatic leg pain.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2020.8.spine20602","type":"journal-article","created":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T07:22:19Z","timestamp":1613114539000},"page":"759-767","source":"Crossref","is-referenced-by-count":17,"title":["Association of extended duration of sciatic leg pain with worse outcome after lumbar disc herniation surgery: a register study in 6216 patients"],"prefix":"10.3171","volume":"34","author":[{"given":"Joel","family":"Beck","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olof","family":"Westin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg; and"},{"name":"Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena","family":"Brisby","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg; and"},{"name":"Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adad","family":"Baranto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg; and"},{"name":"Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"The Adult Spine: Principles and Practice","article-title":"The epidemiology of spinal disorders","author":"Andersson\n \nG.","year":"1997","unstructured":"Andersson\n \nG.\n\n\n \nThe epidemiology of spinal disorders\n. 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