Functional outcome of patients undergoing lumbar discectomy

Abstract

<p class="abstract"><strong>Background:</strong> Sciatica resulting from a lumbar intervertebral disc herniation is the most common cause of radicular leg pain in adult working population. It can be treated with both conservative and operative methods. In our study, surgical treatment of lumbar disc prolapse has been done by open discectomy. We wish to assess the outcome of surgery in patients with lumbar disc prolapse undergoing lumbar discectomy.</p><p class="abstract"><strong>Methods:</strong> 40 patients were included in this study and were followed up for up to 1 year postoperatively. We assessed the outcome of each patient with ODI and VAS post-operatively and on follow-up at 3 weeks, 6 months and 1 year. Subjective evaluation of the patient’s satisfaction at the final follow-up was also done.<strong></strong></p><p class="abstract"><strong>Results:</strong> We found that males had higher incidence of PIVD with an average duration of symptoms before surgery about 8.62 months. Left side was most involved and level l4-l5 was most involved level. The mean ODI and VAS score pre-operatively were 26.85±4.20 and 7.73±0.88 respectively, which changed to 4.48±5.15 and 1.70±1.57, respectively at 1 year post-operative follow-up. These were statistically highly significant. Most of the patients (34) gave a subjective evaluation as excellent at 1 year follow-up.</p><p class="abstract"><strong>Conclusions:</strong> Our study established that open discectomy has a satisfactory functional outcome and leads to a significant improvement in the patients’ quality of life.</p>

A prospective study of functional outcome of lumbar prolapsed intervertebral disc managed with surgical decompression

“…It was observed in the present study that majority of the patients (73.3%) presented with protrusion. This is similar to the study of Singh H et al 6 Who found protrusion in 82.5% patients on MRI. In our study, 3 (10%) patients had complications -2 (6.7%) patients had superficial surgical site infection and 1 (3.3%) patient had dural tear.…”

“…It was observed in the present study that left side was mostly involved (43.3%) followed by right side radiculopathy (36.7%) and bilateral involvement (20%). This is concordant to the study of Singh H et al 6 in which left side was most commonly involved (42.5%). The commonest level of disc prolapse in our study was found to be L4-5 (80%).…”

“…These findings were similar to studies of Mittal A et al 5 (80% male, 20% female), Singh H et al 6 (65% male, 35% female), Swamy A et al 7 (72% males, 28% females) and Chakrabarty PS et al 8 (68% males, 32% females). Singh H et al 6 in their prospective study found majority of patients being manual labours (62.5%), Sangwan SS et al 9 in their study observed that 90% of patients belonged to labour group, Mishra SK et al 10 in their study on 67 patients found 60% (40 patients) were involved in heavy work. The results of our study and other studies suggest that lumbar PIVD is more common among males who are manual labourers performing heavy work.…”

“…In our study, 3 (10%) patients had complications -2 (6.7%) patients had superficial surgical site infection and 1 (3.3%) patient had dural tear. Singh H et al 6 found complication rate was only 10% out of which 2 patients (5%) had superficial surgical site infection and 2 patients (5%) had dural tear. Sangwan SS et al 6 study on Lumbar disc excision reported dural tears in 3 cases, retention urine in 3 cases and transient back pain in 5 patients.…”

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“…Swamy A et al (7) conducted a study on 50 patients of which 4 (8%) patients had prolapsed intervertebral disc at L2-L3 level and 10 (20%) patients had disc prolapsed at L3-L4 level, 22 (44%) patients had disc prolapsed at L4-L5 level and 14 (28%) patients had disc prolapsed at L5-S1 level. Singh H et al 6 in their prospective study observed L4-5 level was most commonly involved level (72.5%). Mittal A et al 5 randomised prospective analysis observed commonest level of disc prolapse was found to be L-4-L5 (80.5%).…”