Duration of sciatica for contained and noncontained lumbar disc herniation: a retrospective study

The objective of this study is to examine the relationship between the duration of sciatica and morphological difference of disc, and to determine the effect of these two factors on the operative results in patients with lumbar disc herniation. Thirty-two patients who were followed for more than 1 year after nucleotomy for lumbar disc herniation at our hospital constituted the base of this study. Patients were divided into three groups by the duration between onset of symptoms and operation. Group A: patients receiving operation within 3 months of onset of symptoms; Group B: from 4 to 11 months after symptom onset; Group C: more than 12 months after symptom onset. Severity of symptoms and operative results were evaluated using JOA scores. JOA scores were not different significantly among three groups at one-year follow-up. However, rate of patients with contained disc was higher in these with longer preoperative duration. In the subsegment analysis, these of 32 patients were divided into two groups, 13 patients with contained disc and 19 patients with noncontained disc. JOA scores before operation were more severe in the noncontained group than in the contained group; however, JOA scores were not different between the groups one-year after operation. In conclusion, it seems that the duration of symptoms is unlikely to influence operative results. Patients with non-contained disc generally had more severe symptoms and thus received operation earlier than patients with contained disc, however, operative results showed no significant difference between patients with contained disc and noncontained disc.