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Title of Journal: Eur Spine J

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Abbravation: European Spine Journal

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Springer Berlin Heidelberg

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DOI

10.1016/0006-8993(94)91950-x

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1432-0932

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Recovery of severe motor deficit secondary to hern

Authors: V R Balaji K F Chin S Tucker L F Wilson A T Casey
Publish Date: 2014/05/29
Volume: 23, Issue: 9, Pages: 1968-1977
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Abstract

The natural history of motor deficit due to lumbar disc herniation has been thought to be favourable However on closer analysis of seminal articles on this topic this is not the case for patients with severe motor deficits MRC grade ≤3 The aim of this study is to answer the following questions 1 Is surgical intervention beneficial in patients with severe motor weakness defined by MRC grade of 3 or less due to herniated lumbar nucleus pulposus 2 Does time to surgery from onset of motor weakness influence the outcome 3 Are there any other prognostic factorsA comprehensive search was conducted in MEDLINE and EMBASE from 1970 upto July 2013 Inclusion criteria for studies are 1 minimum of three patients aged 18 and older who had symptomatic herniated lumbar disc prolapse and underwent surgery 2 description of pre and postoperative muscle weakness utilising the Medical Research Council MRC muscle power grade or equivalent such that both reviewers could confidently identify a cohort of patients with at least grade three motor weakness or worse 3 a minimum of 6 months followupSeven studies were identified with a total of 354 patients Complete recovery was seen in 384  of patients following surgery and 32  following nonoperative treatment Age and grade of motor deficit were identified as significant prognostic factors in some of the studies

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