Factors affecting the quality of life of patients after tubular microdiscectomy

Abstract

Generally accepted factors that may affect a patient's quality of life after surgery include excess body weight and heavy physical activity before surgery. However, randomized controlled clinical trials (RCTs) evaluating the quality of life of patients with these factors after tubular microdiscectomies remain limited.

Objective: to assess the quality of life of patients after tubular microdiscectomy and to establish prognostic factors that affect this indicator.

Materials and methods: The study included 160 consecutive patients who underwent tubular microdiscectomy for herniated intervertebral discs; selected according to the predefined inclusion and exclusion criteria and assessed using the Oswestry Disability Index (ODI). The operations were performed in one institution (Diamed Medical Center, Uzhhorod) by the same surgical team. To identify the most significant variables, backward stepwise regression analysis was applied. The initial model included all potentially relevant variables, after which predictors that did not show a statistically significant association with the dependent variable were sequentially removed. In addition, pairwise correlations among all studied variables were assessed.

Results: It was found that women who had performed heavy physical labor before the operation demonstrated greater variability of ODI indicators compared with women who had not performed heavy physical labor and men from both groups. Prognostic factors for deterioration in quality of life after tubular microscopic discectomy include the combination of heavy physical labor before the operation and a high Body Mass Index (BMI). This pattern became more with increasing patient age.

Conclusions: The quality of life of patients after tubular microscopic discectomy does not depend significantly on individual factors such as gender, age, and physical labor before the operation. Tubular microdiscectomy does not reduce individual factors that potentially affect well-being after the operation; however, it minimizes negative factors during the operation itself and the early postoperative period. To establish the effectiveness of tubular microdiscectomy, further studies are needed to compare pre- and postoperative indicators of different discectomy techniques.