The Surgical Outcome for Prolapsed Lumbar Intervertebral Disc Based on Visual Analog Scores

Abstract

Objective: To determine the surgical Outcome for a prolapsed lumbar intervertebral disc based on a visual analog score.
 Materials and Methods: A prospective study was conducted in the Department of Neurosurgery at Jinnah Postgraduate Medical Centre, Karachi. A total of 55 patients were included in the study. Questionnaires were used to collect demographic data, presenting symptoms, and the level of the herniated discs. The patients underwent different surgical interventions and then these patients were followed for 2 weeks postoperatively and the surgical outcome was assessed using the Visual Analog Score (VAS).
 Results: A total of 34 (61.8%) males and 21 (38.2%) females were included in this study. The average age of the patients was 36.14 ± 9.30 years. L5/S1 was the most commonly affected level. Laminar fenestration was the most common surgical procedure done in 23 (41.8%) patients followed by hemilaminectomy in 19 (34.5%) patients and bilateral laminectomy in 13 (23.6%). Post-operative pain was relieved in the majority of patients which is 43 (78.2%).
 Conclusion: Medical management remains the mainstay in the majority of patients having lumbar disc prolapse. However, in cases where the pain is refractory to conservative management, surgery is considered after careful patient selection. It was seen that surgical intervention successfully reduced the intensity of pain and resulted in a symptomatically improved patient. Hence it is safe to conclude that surgery is an effective measure and ultimately enhances the quality of life.

Efficacy of Fenestration Technique for Lumbar Disc Excision in Pain Relief

“…Early surgical intervention for sciatic pain is more effective than conservative treatment for prolonged period. 13 Ahmed et al reported better results with surgical treatment than conservative management. 14 Standard surgical treatment for protruded disc is excision while there are various methods of excision.…”