A qualidade de vida no pré e pós-operatório de pacientes portadores de hérnia de disco lombar Quality of life in pre- and post-surgical patients with lumbar disc herniation

Introduction: The relevance of the studies that include lumbar disc herniation (LDH) has increased in recent years, mainly because the disease results in pain and neurological deficit, producing impediment for the execution of the daily activities and inability to work. Objective: to evaluate the quality of life and functional scores of patients before and after HDL surgery. Methods: This is a cross-sectional and exploratory study, through the evaluation of questionnaires “Short Form Health Survey (SF-36) and Roland-Morris (RM) in the period April to September of 2008. The sample consisted of 20 patients and the scores were assessed before surgery and two months postoperatively. Results: It was observed that most patients were male (55%), average age 45.5 ± 14, 79 years-old (20-83), with great loss labor pre surgery (60%). There was significant improvement in the areas of the SF-36 for functional capacity, physical aspects, pain and mental health and the Roland Morris functional gains were observed with the decrease of its limitations caused by back. For the analogical scale of pain (VAS), the patients obtained an important reduction of pain: the preoperative average rate was 8,3 points and the postoperative average rate after 60 days was 4.55. Even though 65% have returned to work, only 45% joined the rehabilitation program. Conclusion: Further studies should be conducted so as to provide subsidies to team showing that more than abolishing the pain, functional improvement, expressed by the daily activities, should be modified. An effective approach that includes occupational therapy, physiotherapy and psychology, looking always to operating changes and a better quality of life should be looked for. RESUMO Introducao: A relevância dos estudos que abrangem a hernia de disco lombar (HDL) tem aumentado nos ultimos anos, principalmente porque esta doenca resulta em dor e deficit neurologico, gerando impedimento para a execucao das atividades cotidianas e incapacidade para o trabalho. Objetivo: avaliar a qualidade de vida e o escore funcional de pacientes antes e apos cirurgia de HDL. Casuistica e Metodo: Trata-se de um estudo transversal, exploratorio, mediante a avaliacao dos questionarios “Short Form Health Survey” (SF-36) e “Roland- Morris”(RM) no periodo de abril a setembro de 2008. A amostra foi composta de 20 pacientes e os escores foram avaliados antes da cirurgia e no pos-operatorio de dois meses do procedimento. Resultados: Observou-se que a maioria dos pacientes eram do sexo masculino (n=11, 55%), media de idade de 45,5 ± 14,79 anos (variando de 20 a 83 anos), com grande prejuizo laboral pre cirurgia (60%).Os resultados demonstraram que houve melhora significativa nos dominios do SF-36 para capacidade funcional, aspectos fisicos, dor e saude mental e para o Roland Morris foram observados ganhos funcionais com a diminuicao de suas limitacoes provocadas pelas costas. Pela escala analogica de dor (EVA), os pacientes obtiveram uma diminuicao importante do quadro algico, pois no momento pre-cirurgico obtiveram a media de 8,3 pontos e apos 60 dias da cirurgia uma media de 4,55. Ressalta-se que apesar de 65% dos pacientes retornarem ao trabalho, apenas 45% aderiram a reabilitacao. Conclusao: Novos estudos devem ser realizados de maneira a oferecer subsidios a equipe multiprofissional mostrando que, mais do que abolir a dor, a melhora funcional, expressa pelas atividades cotidianas, deve ser modificada, sendo para isto necessario um enfoque reabilitacional efetivo que inclua a terapia ocupacional, fisioterapia e psicologia, buscando operar mudancas e uma melhor qualidade de vida sempre.