Associations Between Health-Related Quality of Life and Clinical Factors in Lumbar Disc Herniation: Evidence from a Romanian Cohort Using the SF-36.

Background: Lumbar disc herniation (LDH) has a substantial impact on health-related quality of life (HRQoL), mainly through pain, reduced mobility, and functional limitations. To better reflect these outcomes, we utilized the SF-36 survey, a well-established tool commonly used in both clinical and population research. The purpose was twofold: to evaluate HRQoL and to explore the main factors linked with activity limitation in a community-based group of Romanian patients. Methods: This cross-sectional study included 120 participants with LDH who completed the SF-36 questionnaire. Internal consistency was high (Cronbach's α = 0.922). Descriptive statistics, Chi-square tests, t-tests, and multivariate regressions were performed using SPSS 18.0. Results: Of the respondents, 53.3% were female and 58.4% were over 60 years old. While 55% reported good or very good health, 26.7% had severe Daily Activity Limitation (DAL) based on the SF-36 physical function score, and 62.5% scored in the poorer range (33-45) of the Physical and Emotional Status (PES) composite derived from the SF-36. Female sex and age over 60 were each associated with nearly a twofold-higher risk of moderate-to-severe DAL (OR = 2.20, 95% CI: 1.04-4.65), while reporting severe or very severe pain increased this risk more than fourfold (OR = 4.64, 95% CI: 1.89-24.21). Conclusions: In patients with LDH, poor self-rated health, older age, female sex, and high pain intensity were significantly associated with reduced functional capacity. The SF-36 proved to be a valuable tool for identifying vulnerable subgroups that require targeted rehabilitation and psychosocial support. From a public health perspective, these findings also support the use of SF-36 in community screening and in guiding resource allocation for multidisciplinary rehabilitation programs.