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JKM > Volume 42(2); 2021 > Article
Lee, Kim, Jeon, Kim, and Kim: Retrospective Statistical Analysis of Patients with Disc Herniation Treated with Cervical or Lumbar Decompression Treatment

Abstract

Objectives

The purpose of this study was to confirm the relavance between the dependent variables and the treatment effects of nonsurgical spinal decompression(NSD).

Methods

105 patients suffering from disc herniation and treated with NSD were investigated and analyzed.

Results

The intention of retreatment showed a tendency to be higher in having occupation, western treatment only before NSD(WTB) and non-western treatment(WTN) group. As the number of NSD increased, satisfaction score and the Numeric Rating Scale(NRS) difference increased and the NRS after NSD decreased. On the other hand, as western treatment after NSD increased, satisfaction score and the NRS difference decreased and the NRS after NSD increased. The odds ratio of having intention of retreatment was lower in western treatment only after NSD(WTA) group than WTN group. The NRS difference showed a high tendency in the age group of 20s, 60s, and 70s and older. The NRS difference of group with NSD more than 10 times was higher than that of the group with less than 10 times. Satisfaction score of WTN and WTB group was higher than that of WTA group. Adjusted NRS after NSD was the lowest in non-western treatment group and the highest in WTA group. Adjusted NRS after NSD was the lowest in the group with NSD over 21 times, and the NRS after NSD increased as the number of NSD decreased.

Conclusion

This study included patients with cervical or lumbar disc herniation and showed that occupation, the number of NSD, western treatment and age statistically affected the treatment effect.

Fig. 1
Study flow chart
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Fig. 2
NRS difference for the number of NSD
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Fig. 3
Satisfaction score for western treatment
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Fig. 4
Adjusted NRS after NSD for the number of NSD
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Fig. 5
Adjusted NRS after NSD for western treatment
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Table 1
Frequency analysis of demographic variables
Variables No. %
Sex Male 50 47.6
Female 55 52.4

Age 1–29 9 8.6
30–39 12 11.4
40–49 25 23.8
50–59 32 30.5
60–69 19 18.1
70- 8 7.6

Mean±SD 50.56±3.339

Occupation Yes office worker 45 42.9
part time job 3 2.9
self-employed 2 1.9

No unemployed 43 41.0
student 6 5.7

Body weight(kg) −55 14 13.3
−65 30 28.6
−75 28 26.7
−85 22 21.0
Over 85 11 10.5

Mean±SD 68.71±3.231

SD : Standard Deviation

Table 2
Frequency analysis of disease variables
Variables No. %
Site of disease Cervical 36 34.3
Lumbar 69 65.7

Stage of disc herniation Bulging 17 16.2
Protrusion 58 55.2
Extrusion 28 26.7
Sequestration 2 1.9

Radiating pain Yes left 43 41.0
right 28 26.7
both 11 10.5

No 23 21.9

Duration of disease Acute 26 24.8
Subacute 8 7.6
Chronic 71 67.6
Table 3
Frequency analysis of therapeutic variables
Variables No. %
Admission Yes 60 57.1
No 45 42.9

Disc Level of NSD C3–4 2 1.9
C4–5 3 2.9
C5–6 22 21.0
C6–7 9 8.6
L1–2 1 1.0
L2–3 1 1.0
L3–4 2 1.9
L4–5 43 41.0
L5–S1 22 21.0

Number of NSD 1–5 26 24.8
6–9 26 24.8
10 23 21.9
11–20 18 17.1
21- 12 11.4

Mean±SD 11.35±0.191

Increase ratio of NSD(Cervical) (%) 0 – 10 8 7.6
−12 10 9.5
−14 10 9.5
Over 14 8 7.6

Mean±SD 12.5±.15

Increase ratio of NSD(Lumbar) (%) −50 9 8.6
−60 14 13.3
−70 18 17.1
−80 18 17.1
Over 80 10 9.5

Mean±SD 66.05±3.644

Western Treatment WTN 57 54.3
WTB 32 30.5
WTA 7 6.7
WTBA 9 8.6

SD : Standard Deviation

WTN : Non-Western Treatment

WTA : Western Treatment only after NSD

NSD: Nonsurgical Spinal Decompression

WTB : Western Treatment only before NSD

WTBA : Western Treatment both before and after NSD

Table 4
Frequency analysis of therapeutic effectiveness
Variables No. %
Satisfaction score 1 4 3.8
2 19 18.1
3 26 24.8
4 47 44.8
5 9 8.6

Mean±SD 3.36±.001

Intention of retreatment Yes 64 61.0
No 41 39.0

NRS B Mean±SD 6.38±.104

NRS A Mean±SD 4.42±.406

NRS B – NRS A Mean±SD 1.962±.808

SD : Standard Deviation

NRS : Numeric Rating Scale

NRS A : NRS After NSD

NSD : Nonsurgical Spinal Decompression

NRS B : NRS Before NSD

Table 5
Crossover analysis of occupation and intention of retreatment
Variables Intention of retreatment Total x2

Yes No
Occupation Yes N 41 15 56 7.581 (0.006**)
% 73.2 26.8 100.0

No N 23 26 49
% 46.9 53.1 100.0

Total N 64 41 105
% 61.0 39.0 100.0

** p < 0.01

Table 6
Crossover analysis of western treatment and intention of retreatment
Variables Intention of retreatment Total x2

Yes No
Western Treatment WTN N 36 21 57 9.156 (0.027*)
% 63.2 36.8 100.0

WTB N 23 9 32
% 71.9 28.1 100.0

WTA N 1 6 7
% 14.3 85.7 100.0

WTBA N 4 5 9
% 44.4 55.6 100.0

Total N 64 41 105
% 61.0 39.0 100.0

* p < 0.05

NSD: Nonsurgical Spinal Decompression

WTB : Western Treatment only before NSD

WTBA : Western Treatment both before and after NSD

WTN : Non-Western Treatment

WTA : Western Treatment only after NSD

Table 7
Multiple linear regression analysis of satisfaction score
Independent variable Unstandardized Standardized t p Collinearity statistics F (p)
B SE beta TOL VIF
Constant 3.740 .670 5.579 .000 2.966 (.004**)
Sex −.182 .201 −.091 −.905 .368 .813 1.230
Age −.008 .008 −.111 −1.107 .271 .814 1.229
Stage of disc herniation .137 .147 .096 .930 .355 .778 1.286
Radiating pain −.382 .229 −.158 −1.670 .098 .913 1.095
Duration of disease .083 .113 .072 .739 .462 .870 1.149
Admission −.021 .193 −.010 −.108 .914 .893 1.119
Number of NSD .023 .010 .236 2.419 .017* .860 1.163
WT before NSD .050 .209 .025 .241 .810 .786 1.273
WT after NSD −.852 .265 −.307 −3.212 .002** .898 1.113
Dependent variable : Satisfaction score

* p < 0.05

** p < 0.01

SE : Standard Error

VIF : Variance Inflation Factor

WT : Western Treatment

TOL : Tolerance

NSD : Nonsurgical Spinal Decompression

Table 8
Multiple linear regression analysis of the NRS difference
Independent variable Unstandardized Standardized t p Collinearity statistics F (p)
B SE beta TOL VIF
Constant 1.693 1.188 1.425 .157 3.483 (.001***)
Sex −.132 .355 −.037 −.372 .711 .813 1.230
Age −.002 .013 −.015 −.153 .879 .814 1.229
Stage of disc herniation .226 .261 .087 .866 .389 .778 1.286
Radiating pain −.438 .405 −.101 −1.082 .282 .913 1.095
Duration of disease .092 .199 .044 .460 .646 .870 1.149
Admission −.360 .342 −.099 −1.051 .296 .893 1.119
Number of NSD .074 .017 .416 4.338 .000*** .860 1.163
WT before NSD .102 .370 .028 .277 .782 .786 1.273
WT after NSD −1.018 .470 −.203 −2.166 .033* .898 1.113
Dependent variable : NRS B – NRS A

* p < 0.05

*** p= < 0.001***

SE : Standard Error

VIF : Variance Inflation Factor

NRS : Numeric Rating Scale

NRS A : NRS After NSD

TOL : Tolerance

NSD : Nonsurgical Spinal Decompression

NRS B : NRS Before NSD

WT : Western Treatment

Table 9
Multiple linear regression analysis of the NRS after NSD
Independent variable Unstandardized Standardized t p Collinearity statistics F (p)
B SE beta TOL VIF
Constant 3.819 .954 4.004 .000 2.619 (.009**)
Sex .017 .285 .006 .061 .952 .813 1.230
Age .007 .011 .067 .663 .509 .814 1.229
Stage of disc herniation −.113 .209 −.056 −.540 .591 .778 1.286
Radiating pain .423 .325 .125 1.302 .196 .913 1.095
Duration of disease −.022 .160 −.013 −.136 .892 .870 1.149
Admission .233 .275 .082 .848 .398 .893 1.119
Number of NSD −.033 .014 −.241 −2.430 .017* .860 1.163
WT before NSD .061 .297 .021 .206 .837 .786 1.273
WT after NSD 1.305 .377 .335 3.460 .001*** .898 1.113
Dependent variable : NRS A

* p<0.05

** p<0.01

*** p=< 0.001

SE : Standard Error

VIF : Variance Inflation Factor

NRS : Numeric Rating Scale

WT : Western Treatment

TOL : Tolerance

NSD : Nonsurgical Spinal Decompression

NRS A : NRS After NSD

Table 10
Logistics regression analysis of intention of retreatment
Independent variable B SE Wald 95% CI p Exp(B)
Min Max
Western Treatment WTN 6.925 . 074
WTB .399 .480 .693 .582 3.816 .405 1.491
WTA −2.331 1.114 4.374 .011 .864 .036* .097
WTBA −.762 .725 1.106 .113 1.932 .293 .467
Dependent variable : Intention of retreatment

* p<0.05

SE : Standard Error

WTN : Non-Western Treatment

WTA : Western Treatment only after NSD

CI : Confidence Interval

WTB : Western Treatment only before NSD

WTBA : Western Treatment both before and after NSD

Table 11
ANOVA of age and the NRS difference
Variables NRS A – NRS B F p Scheffe

No. Mean SD
Age 1–29 9 3.4444 1.94365 2.545 0.033*
30–39 12 2.0000 1.47710
40–49 25 1.6800 1.74929
50–59 32 1.3750 1.69915
60–69 19 2.3158 1.82734
70- 8 2.6250 1.84681

* p < 0.05

SD : Standard Deviation

NRS B : NRS Before NSD

NRS : Numeric Rating Scale

NRS A : NRS After NSD

Table 12
ANOVA of the number of NSD and the NRS difference
Variables NRS B – NRS A F p Scheffe
No. Mean SD
Number of NSD 1–5(a) 26 1.0000 1.13137 8.239 0.000*** e,d,c>b,a
6–9(b) 26 1.1538 1.12044
10(c) 23 2.6087 1.97114
11–20(d) 18 2.8333 1.72354
21-(e) 12 3.2500 2.26134

*** p < 0.001

NSD: Nonsurgical Spinal Decompression

NRS : Numeric Rating Scale

NRS A : NRS After NSD

SD : Standard Deviation

NRS B : NRS Before NSD

Table 13
ANOVA of western treatment and satisfaction score
Variables Satisfaction score F p Scheffe
No. Mean SD
Western Treatment WTA (a) 7 2.14 1.069 4.871 0. 003** d,c>a
WTBA (b) 9 3.00 1.000
WTB (c) 32 3.47 0.718
WTN (d) 57 3.51 1.037

** p < 0.01

NSD: Nonsurgical Spinal Decompression

WTB : Western Treatment only before NSD

WTBA : Western Treatment both before and after NSD

WTN : Non-Western Treatment

WTA : Western Treatment only after NSD

Table 14
ANCOVA of western treatment and the NRS after NSD
Western treatment No. Adjusted Mean SE 95% CI Type III SS F-value (p-value)
Min Max
WTN 57 4.182 0.179 3.827 4.537 24.484 4.510 (0.005**)
WTB 32 4.288 0.238 3.816 4.761
WTA 7 5.872 0.509 4.863 6.882
WTBA 9 5.254 0.451 4.359 6.149

** p < 0.01

SE : standard error

Type III SS : Type III sum of squares

WTN : Non-Western Treatment

WTA : Western Treatment only after NSD

CI : Confidence Interval

NSD: Nonsurgical Spinal Decompression

WTB : Western Treatment only before NSD

WTBA : Western Treatment both before and after NSD

Table 15
ANCOVA of the number of NSD and the NRS after NSD
Number of NSD No. Adjusted Mean SE 95% CI Type III SS F-value (p-value)
Min Max
1–5 26 4.967 0.276 4.419 5.516 20.526 2.747 (0.032*)
6–9 26 4.845 0.275 4.299 5.391
10 23 4.071 0.289 3.497 4.644
11–20 18 3.878 0.327 3.230 4.526
21- 12 3.786 0.409 2.975 4.597

* p < 0.05

SE : standard error

Type III SS : Type III sum of squares

CI : Confidence Interval

NSD: Nonsurgical Spinal Decompression

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