Wait time to lumbar discectomy linked to post-op pain

(HealthDay)—The likelihood of experiencing worse pain at six months post-surgery is increased with a waiting time of 12 weeks or more for elective surgical lumbar discectomy (ESLD), according to a study published in the Dec. 1 issue of The Spine Journal.

Jeffrey A. Quon, D.C., Ph.D., from the University of British Columbia in Vancouver, Canada, and colleagues assessed whether a system-imposed delay in treatment (a longer waiting time) for ESLD correlates with residual postoperative pain in a cohort of 291 patients, aged 16 years or older with advanced imaging-confirmed sciatica because of herniated lumbar disc, but excluding those with significant comorbidity or emergency indications for surgery. Pain intensity was assessed on the 11-point numerical rating scale at waitlist enrollment and six months postoperatively.

The researchers found that at six months, long-wait patients were 80 percent more likely than short-wait patients to experience higher ordinal pain intensity in unadjusted analyses (unadjusted proportional odds ratio [POR], 1.8). After controlling for all imbalances in measured confounders the association persisted, with long-wait patients 70 percent more likely to report worse pain (adjusted POR, 1.7).

"In jurisdictions where highly constrained access to ESLD is managed through waitlists, the expected waiting time for the operation could be an informative deciding criterion for patients with otherwise unresolved preferences for operative treatment," the authors write.

Several authors disclosed financial ties to the medical device industry.

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