Effectiveness of Lumbosacral Orthosis After Discectomy for Lumbar Disk Herniation: A Prospective Comparative Study

Prospective comparative study.To investigate the benefits of postoperative application of lumbosacral orthosis after single-level discectomy for lumbar disc herniation (LDH).Although many surgeons use postoperative lumbosacral orthosis for patients with LDH, there is no clear evidence to support or deny its effectiveness.Ninety-nine consecutive patients who underwent the microscopic discectomy were included. They were divided into two groups: Orthosis group and Non-orthosis group, before surgery. The recurrence rate and reoperation rate were compared between the two groups at 4-week, 6-month and 1-year follow-up. Japanese Orthopaedic Association Score for lumbar spine (L-JOA score) at 2-week and 1-year follow-up, lower extremities and low back pain's visual analog scale (VAS) and Oswestry Disability Index (ODI) at 6-month and 1-year follow-up were compared.Forty-two patients in the Orthosis group and 39patients in the Non-orthosis group were followed up for at least 1-year after surgery. Recurrence occurred in 3 patients (7.1%) in the Orthosis group and 6 (15.4%) in the Non-orthosis group within 1-year. Two patients (4.8%) in the Orthosis group and 2 patients (5.1%) in the Non-orthosis group underwent reoperation. There were no significant intergroup differences in the recurrence rate and in the reoperation rate. No significant difference was also observed between the two groups in L-JOA score, ODI, VAS of low back pain, and leg pain at 1-year after surgery. Furthermore, at any other follow-up period, no significant differences were observed between the two groups in recurrence rate, reoperation rate, L-JOA score, VAS of low back/leg pain, or ODI.Postoperative orthosis did not reduce the recurrence/ reoperation rates, nor improve postoperative clinical symptoms. Routine use of orthosis may not be necessary after single-level lumbar discectomy.