Correlation between Pain Scores and Disc Height Changes after Discectomy in Patients with Lumbar Disc Herniation: A Systematic Review and Meta-Analysis

Abstract

Background. Surgery can reduce and improve lumbar disc herniation, but some patients still have pain after surgery, and the relationship between lumbar disc height and pain after surgery is still unclear. Objective. The main objective is to investigate the relationship between lumbar disc height and postoperative pain. Methods. We searched Pubmed, Web of Science, the Cochrane library, and Embase online for cohort studies or RCT studies on discectomy and assessed the quality of the included articles using the Newcastle-Ottawa Scale (NOS scale), with disc height (DH) and postoperative back pain as the main clinical outcome indicators, and the correlation coefficient between DH and back pain as the statistic to assess the pooled effect size. Results. 10 kinds of literature were included in this study for quantitative analysis. A total of 589 patients participated in the study. The follow-up time was between 1 and 2.3 years. Meta-analysis showed that after surgery, the relief of back pain was statistically significant (MD = −2.57, 95% CI (−3.10,−2.04), Z = −9.570, $P<0.0001$ ), the reduction of disc height was statistically significant (MD = −0.82, 95% CI (−1.11, −0.52), Z = −5.477, $P<0.0001$ ), the combined value of correlation coefficient Fisher’s Z value was 0.33, 95% CI (0.25,0.42), with statistical significance ( $P<0.00001$ ), suggesting that the degree of back pain after surgery showed a moderate positive correlation with disc height in the short term. Discussion. After discectomy, the degree of pain is relieved, the disc height is reduced, and low back pain in the short term and disc height showed a moderate positive correlation, but the long-term correlation remains to be studied in depth.