Changes in radicular function following low-back surgery

Gerhard Blaauw M.D., Ph.D.1, Reinder Braakman M.D., Ph.D.1, Geert Jan Gelpke M.Sc.1, and Ram Singh M.D., Ph.D.1
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  • 1 Departments of Neurosurgery, St. Clara Hospital, University Hospital Rotterdam-Dijkzigt, and St. Franciscus Hospital; and Department of Public Health and Social Medicine, Erasmus University, Rotterdam, The Netherlands
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✓ Results of neurological assessment 1 year following surgical treatment of herniated lumbar intervertebral discs and lumbar stenosis are reported in 443 patients. The data were collected using separate series of questionnaires to be completed by the patient and the surgeon. Preoperatively, motor loss was reported by 12% of patients, while surgeons found motor weakness in 28%. Postoperative motor loss was still present in 24% and 25% of these cases, respectively; the operation had caused or aggravated motor loss in 5% and 3% of cases, respectively. Sensory phenomena were reported by 53% of the patients, while surgeons found sensory loss in 45%. Sensation was reported as abnormal 1 year after surgery both by patients and by surgeons in one-third of these cases. Sensory loss, considered by the patient to be caused or aggravated by operation, occurred in 15% of cases and in 12% of cases the surgeons agreed. Preoperatively, unilaterally diminished knee and Achilles tendon reflexes were found in 9% and 42%, respectively; at 1 year after surgery, these had recovered in 65% and 57% of cases, respectively. Surgery caused or aggravated unilaterally diminished knee or ankle jerks in 3% and 10% of cases, respectively.

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