Lumbosacraal Radiculair Syndroom in de eerste lijn; tien jaar follow-up.

Background. A lumbosacral radicular syndrome (LRS) is an acute problem, often with a prolonged course. To gain insight into the consultation of patients with LRS at primary care, there is an ongoing short-term follow-up database-study. This study describes the course in the longer term, focusing on the care of patients with LRS consumption during an average period of 10 years. Methods. A cohort of 576 patients suffering from new complaints of LRS in 1998 or 1999 was selected from the database of the Registration Network Groningen (RNG). Data from these patients were supplemented with information from case studies in 3 general practices. 390 patients were included for further analysis and were followed until December 2008. From these patients, data were analyzed for the number of contacts with the GP, history and prognosis, medication prescribed, referrals and operations because of a LRS. Incidence and prevalence rates were calculated for the population in the RNG database, during the period 1998-2008. Results. The incidence of LRS was 9.4 per 1000 person years, the prevalence was 17.2 per 1000 person years. Prior to a LRS 46% of the patients had back pain, 43% of the patients suffered from back pain after an episode LRS. Throughout the study period, patients consulted their GP on average 3.4 times because of a LRS. Almost 40% of the patients consulted their GP only once. After 10 years, the likelihood that patients visited their GP because of an LRS was approximately 2%. Patients with a history of back pain and undergoing surgery due to an LRS, had significantly longer contact with their GP. Throughout the study period 64% of the patients received a prescription for medication, especially NSAIDs. Almost 53% of the patients were referred, mostly to the physiotherapist and/or neurologist. Throughout the study period 8.7% of the patients were operated because of a LRS. Conclusion. The health care consumption of approximately 40% of patients with LRS consisted of a single contact with the GP. The remaining 60% had more contacts with their GP because of a LRS. Over 10 years follow-up patients with LRS are visiting their GP on average 3.4 times. Men have fewer contacts with their GP than women, but they are equally referred and even more operated. Most contacts take place within one year after diagnosing LRS. The likelihood of contact with the GP after 10 years follow-up is approximately 2%. Patients with a history of back pain and surgical patients have significantly more contacts with their GP compared with patients without a history of back pain or surgery.