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How Fast Pain, Numbness, and Paresthesia Resolves After Lumbar Nerve Root Decompression: A Retrospective Study of Patient's Self-reported Computerized Pain Drawing

Huang, Peng MD*; Sengupta, Dilip K. MD, Dr. Med

Spine:
doi: 10.1097/BRS.0000000000000240
Health Services Research
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Abstract

Study Design. A single-center retrospective study.

Objective. To compare the speed of recovery of different sensory symptoms, pain, numbness, and paresthesia, after lumbar nerve root decompression.

Summary of Background Data. Lumbar radiculopathy is characterized by different sensory symptoms like pain, numbness, and paresthesia, which may resolve at different rates after surgical decompression.

Methods. Eighty-five cases with predominant lumbar radiculopathy treated surgically were reviewed. Oswestry Disability Index score, 36-Item Short Form Health Survey scores (Physical Component Summary and Mental Component Summary), and pain drawing at preoperative and at 6 weeks, 3 months, 6 months, and 1-year follow-up were reviewed. Recovery rate between different sensory symptoms were compared in all patients, and between the short-term compression (<6 mo) and long-term compression groups.

Results. At baseline, 73 (85.8%) patients had pain, 63 (74.1%) had numbness, and 38 (44.7%) had paresthesia; 28 (32.9%) had all these 3 component of sensory symptoms. Mean pain score improved fastest (55.3% at 6 wk); further resolution until 1 year was slow and not significant compared with each previous visit. Both numbness and paresthesia scores showed a trend of faster recovery during the initial 6-week period (20.5% and 24%, respectively); paresthesia recovery reached a plateau at 3 months postoperatively, but numbness continued a slow recovery until 1-year follow-up. Both Oswestry Disability Index score and Physical Component Summary scores (54.02 ± 1.87 and 26.29 ± 0.93, respectively, at baseline) improved significantly compared with each previous visits at 6 weeks and 3 months postoperatively, but further improvement was insignificant. Mental Component Summary showed a similar trend but smaller improvement. The short-term compression group had faster recovery of pain than the long-term compression group.

Conclusion. In lumbar radiculopathy patients after surgical decompression, pain recovers fastest, in the first 6 weeks postoperatively, followed by paresthesia recovery that plateaus at 3 months postoperatively. Numbness recovers at a slower pace but continues until 1 year.

Level of Evidence: 4

In Brief

Periodic pain diagram in 85 lumbar radiculopathy cases with predominant leg pain, treated with surgical decompression with/without fusion, showed pain component resolves first, followed by gradual improvement of paresthesia, and slow but continued improvement of numbness during 1-year follow-up after surgery.

Author Information

*Department of Orthopaedics, Chinese PLA General Hospital, Beijing, China; and

Department of Orthopaedics, Dartmouth-Hitchcock Medical Center, Lebanon, NH.

Address correspondence and reprint requests to Dilip K. Sengupta, MD, Dr. Med, Department of Orthopaedics, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756; E-mail: dksg@hotmail.com

Acknowledgment date: March 18, 2013. Revision date: December 2, 2013. Acceptance date: January 2, 2014.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work.

Relevant financial activities outside the submitted work: board membership, consultancy, grants, royalties, stocks.

© 2014 by Lippincott Williams & Wilkins