Issue release date: 12.11.2024
2Erciyes University, School of Medicine, Department of Neurosurgery, Kayseri, Turkey DOI : 10.5137/1019-5149.JTN.26988-19.1 AIM: To investigate the incidence of neuropathic pain (NP) in patients with foraminal/extraforaminal lumbar disc herniation (FEFLDH), the prognosis of NP and the effect of microsurgery on patients treatment.
MATERIAL and METHODS: Two patient groups with FEFLDH were investigated: the surgery group underwent surgical treatment, and the medical-treated group received medical treatment. Patients were diagnosed with NP when the Self-Administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) pain scale was ⥠12 points. The NP scores were evaluated during patient admission and at 1, 6 and 12 months postoperation or during medical treatment.
RESULTS: The surgery group included 37 patients (18 women, 19 men); FEFLDHs were localised at the L3â4 (n=9), L4â5 (n=23) and L5âS1 (n=5) levels. NP was detected in 16 patients before surgery (43%). The medical-treated group included 46 patients (19 women, 27 men); FEFLDHs were localised at the L2â3 (n=7), L3â4 (n=12) and L4â5 (n=27) levels. NP was detected in 20 patients before medical treatment (43%). The most common neuropathic symptom for patients was a burning sensation. NP was found more common in patients who were of at advanced age (> 65 years) (p=0.019), had a longer clinical duration (p=0.007) or had a foraminal disc herniation (p=0.038).
CONCLUSION: Chronic compression of the dorsal root ganglion by FEFLDH is a significant cause of NP. If surgical treatment is delayed for FEFLDH, the risk of persistent NP may increase.
Keywords : Dorsal root ganglia, Lumbar disc herniation, Neuropathic pain, Surgical timing, Transmuscular intertransverse surgery