Lumbar discectomy is commonly performed for patients with symptomatic lumbar disc herniation (SLDH). As estimates of pain after surgery include individuals whose pain never resolved, counseling of patients with good pain resolution after surgery is somewhat difficult. This study was designed to identify the cumulative risks of recurrent leg and low back pain following discectomy for SLDH.

This study was a secondary analysis of data from the Spine Patient Outcomes Research Trial (SPORT), a randomized trial of adults with chronic radicular pain, with MRI findings corresponding with clinical presentation. Patient reported outcomes were evaluated at baseline, at three months and then at one, two, three and four years post-surgery. Outcome measures included the Sciatica Bothersomeness Index (SBI). Pain resolution was defined as having a SBI index score of two or greater before surgery and less than two following surgery. Of the 788 patients who received surgery, 71% had a resolution of leg pain and 52% a resolution of low back pain. The cumulative risks of leg pain recurrence were 20% at one year and 45% at three years. The cumulative risk of low back pain recurrence was 29% at one year and 65% at three years.

Multivariate analysis revealed that complete leg pain resolution after surgery predicted a lower risk of recurrence, while depression and smoking predicted a greater risk of recurrent leg pain. For recurrence of low back, greater age and current employment predicted a lower risk of recurrence, while being divorced or widowed, as well as having joint problems, predicted a greater risk.

This study of patients undergoing discectomy found the cumulative risks of recurrent leg pain and back pain were 20% and 29%, respectively, at one year post-surgery.