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Nonsurgical treatment outcomes for surgical candidates with lumbar disc herniation: a comprehensive cohort study

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dc.contributor.author신동아-
dc.contributor.author조용은-
dc.date.accessioned2022-09-14T01:13:36Z-
dc.date.available2022-09-14T01:13:36Z-
dc.date.issued2021-02-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/190353-
dc.description.abstractPhysicians often encounter surgical candidates with lumbar disc herniation (LDH) who request non-surgical management even though surgery is recommended. However, second opinions may differ among doctors. Therefore, a prospective comprehensive cohort study (CCS) was designed to assess outcomes of nonsurgical treatment for surgical candidates who were recommended to undergo surgery for LDH but requested a second opinion. The CCS includes both randomized and observational cohorts, comprising a nonsurgery cohort and surgery cohort, in a parallel fashion. Crossover between the nonsurgery and surgery cohorts was allowed at any time. The present study was an as-treated interim analysis of 128 cases (nonsurgery cohort, n = 71; surgery cohort, n = 57). Patient-reported outcomes included visual analogue scores for the back (VAS-B) and leg (VAS-L), the Oswestry Disability Index, the EuroQol 5-Dimension instrument, and the 36-Item Short-Form Health Survey (SF-36), which were evaluated at baseline and at 1, 3, 6, 12, and 24 months. At baseline, age and SF-36 physical function were significantly lower in the surgery cohort than in the nonsurgery cohort (p < 0.05). All adjusted outcomes significantly improved after both nonsurgical and surgical treatment (p < 0.05). The nonsurgery cohort showed less improvement of VAS-B and VAS-L scores at 1 month (p < 0.01), but no difference between cohorts was observed thereafter for 24 months (p > 0.01). Nonsurgical management may be a negotiable option even for surgical candidates in the shared decision-making process.-
dc.description.statementOfResponsibilityopen-
dc.languageEnglish-
dc.publisherNature Publishing Group-
dc.relation.isPartOfSCIENTIFIC REPORTS-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHAdult-
dc.subject.MESHConservative Treatment / statistics & numerical data*-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHIntervertebral Disc Degeneration / therapy*-
dc.subject.MESHIntervertebral Disc Displacement / therapy*-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHProspective Studies-
dc.titleNonsurgical treatment outcomes for surgical candidates with lumbar disc herniation: a comprehensive cohort study-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Neurosurgery (신경외과학교실)-
dc.contributor.googleauthorChi Heon Kim-
dc.contributor.googleauthorYunhee Choi-
dc.contributor.googleauthorChun Kee Chung-
dc.contributor.googleauthorKi-Jeong Kim-
dc.contributor.googleauthorDong Ah Shin-
dc.contributor.googleauthorYoun-Kwan Park-
dc.contributor.googleauthorWoo-Keun Kwon-
dc.contributor.googleauthorSeung Heon Yang-
dc.contributor.googleauthorChang Hyun Lee-
dc.contributor.googleauthorSung Bae Park-
dc.contributor.googleauthorEun Sang Kim-
dc.contributor.googleauthorHyunsook Hong-
dc.contributor.googleauthorYongeun Cho-
dc.identifier.doi10.1038/s41598-021-83471-y-
dc.contributor.localIdA02092-
dc.contributor.localIdA03865-
dc.relation.journalcodeJ02646-
dc.identifier.eissn2045-2322-
dc.identifier.pmid33594185-
dc.contributor.alternativeNameShin, Dong A-
dc.contributor.affiliatedAuthor신동아-
dc.contributor.affiliatedAuthor조용은-
dc.citation.volume11-
dc.citation.number1-
dc.citation.startPage3931-
dc.identifier.bibliographicCitationSCIENTIFIC REPORTS, Vol.11(1) : 3931, 2021-02-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers

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