Desfechos clínicos e funcionais em pacientes submetidos a cirurgia precoce comparado a cirurgia tardia para hérnia de disco lombar: uma revisão sistemática

Abstract

The objective of this study was to verify results of clinical and functional outcomes in patients undergoing early surgery versus those undergoing late surgery for lumbar disc herniation through a systematic literature review. The search strategy was carried out in the MEDLINE / PubMed, Web of Science and Scopus databases from September to November 2019, with studies published from 1950 to July 2019. The following terms were used, individually, in the each database: herniated lumbar disc, disc prolapse, disc herniation surgery, lumbar discectomy, lumbar disc herniation, lumbar radiculopathy, lumbar microdiscectomy, clinical outcome, predictive factor, disability and chronic pain. In order to combine the terms, Boolean operators ―OR and ―AND were used. After applying the eligibility criteria, 10 studies were selected for review. Among these, two were considered to be from the early surgery group, six from the late surgery group and in four studies it was not possible to identify defining the time of the surgical procedure. The included studies showed marked heterogeneity in relation to the assessment instruments used to measure pain and to assess patients' functional capacity, as well as the different moments adopted to perform postoperative and follow-up assessments. Based on the available evidence,it is concluded that the literature available in the area is not sufficient to state whether there is a benefit from early surgery for lumbar disc herniation, in favor of late surgery, in the evaluated clinical and functional outcomes.