Background: Spinal disc herniation (cervical and/or lumbar) is common and can cause significant pain (localized or radicular) disability. Up to authors' knowledge, no systematic review was identified to provide the best available evidence about the relation between the size of herniated disc and pain severity level in patients.
Purpose: To pool and summarize the published research evidence examining the relationship between size of herniated spinal disc and pain severity level in patients with spinal disc herniation.
Methods: Three databases; PubMed, Cochrane, and Scopus were searched for all the studies published in English and free full text that have studied the relationship between size of herniated spinal disc and pain severity level in patients.
Results: Thirty-one studies that met the inclusion criteria were identified, with a total of 2400 participants. All studies have fair to high quality except one case report. 17 studies of 879 participants found a direct relation and 9 studies of 1041 participants found no relation, 2 studies of 228 participants found inverse relation and 3 studies of 252 participants showed inconsistent results.
Conclusions: The current evidence is inconclusive with respect to the relation of the size of herniated disc and pain severity level. This finding at least lowers the current importance of imaging and need for surgery in cases suspected to disc herniation or confirmed on MRI unless severe progressive neurological deficits and pain were present. However, further high quality studies are needed to confirm that findings. |
