Microscopic Discectomy Outcomes in Lumbar Disc Herniation Patients

  • HASSAAN ZAHID Departments of Neurosurgery and 2Histopathology, PGMI Lahore General Hospital Lahore
  • IMRAN ALI Departments of Neurosurgery and 2Histopathology, PGMI Lahore General Hospital Lahore
  • NABEEL CHOUDHARY Departments of Neurosurgery and 2Histopathology, PGMI Lahore General Hospital Lahore
  • JUNAID RASHID Departments of Neurosurgery and 2Histopathology, PGMI Lahore General Hospital Lahore
  • KHALID MEHMOOD Departments of Neurosurgery and Histopathology, PGMI Lahore General Hospital Lahore
Keywords: Herniated Lumbar Disc, Microscopic Discectomy, Postoperative Pain

Abstract

Background: Radiculopathy due to herniated lumbar disc is one of the most common determinant of sciatica. Most patients with sciatica respond well to non-surgical treatment. Surgery is performed when there is an established neurological deficit or when conservative management is not successful in achieving positive results in pain.
Objective: To evaluate the frequency of good outcomes regarding pain relief after lumbar microscopic discectomy in adult patients presenting with radiculopathy.
Material and Methods: Current study includes 80 patients, both male and female between 20-70 years and admitted for herniated lumbar disc surgery. Microscopic discectomy was performed in all these patients. Outcome variable was frequency of good outcome in terms of post-operative pain ≤ 4/10. Informed consent in written was obtained from the individual patient.
Results: In 73 (91.3%) cases good outcome was observed. No substantial difference was noticed in the frequency of good outcome according to the duration of herniated disc (p = 0.960), pre-operative pain score (p = 0.499), age (p = 0.851) and gender (p = 0.703).
Conclusion: Good outcome was observed in 91.3% patients presenting with herniated lumbar disc undergoing microscopic discectomy regardless of patient’s age, gender, pre-operative pain and duration of disc herniation.

References

Frymoyer JW. Back pain and sciatica. N Engl J Med. 1988; 318 (5): 291-300.
2. Dewing CB, Provencher MT, Riffenburgh RH, Kerr S, Manos RE. The outcomes of lumbar microdiscectomy in a young, active population: correlation by herniation type and level. Spine, 2008; 33 (1): 33-6.
3. Ullrich J, Peter F. Microdiscectomy Spine Surgery: Risks, Complications, and Success Rates. 2016 [cited 2016]; Available from; http://www.sDine-health.com/treatment/back-suraervAnicrodiscectomvsoine-suroerv-risks-complications-and-success-rates.
4. Best NM, Sasso RC. Outpatient Microdiscectomy for Lumbar Disc Herniation in Adolescent Patients: Long-Term Follow-up Study. Indiana Orthop J. 2010; 4: 70-3.
5. Pappas CT, Harrington T, Sonntag VK. Outcome analysts in 654 surgically treated lumbar disc herniations. Neurosurgery, 1992; 30 (6): 862-6.
6. Schoeggl A, Reddy M, Matula C. Functional and economic outcome following microdiscectomy for lumbar disc herniation in 672 patients. J Spin Disord Tech. 2003; 16 (2): 150-5.
7. Quigley MR, Bost J, Maroon JC, Elrifai A, Panahandeh M. Surg Neurol. 1998; 49 (3): 263-7.
8. Khan MA, Ahmed M, Ali S. Comparison of outcome in microdiscectomy v/s conventional discectomy. Pak J Neurol Surg. 2015; 19 (4): 287-91.
9. Khan Z, Sharafat S, Ali M. Surgical outcome after micro discectomy for lumbar disc herniation. J Med Sci (Peshawar, Print), 2013; 21 (2): 74-6.
10. Shrestha D, Shrestha R, Dhoju D, Kayastha SR, Jha SC. Study of clinical variables affecting long term outcome after microdisectomy for lumbar disc herniaion. Kathmandu Univ Med J. 2015; 52 (4): 333-40.
11. Bhatia PS, Chhabra HS, Mohapatra B. Microdiscectomy or tubular discectomy: Is any of them a better option for management of lumbar disc prolapse. J Cranio Spine, 2016; 7 (3): 146-52.
12. Abouelela AA, Morsi AM, Khattab MF. Microscopic lumbar discectomy. Egyptian Orthop J. 2015; 50 (1): 15-9.
13. Omidi-Kashani F, Jarahi L, Jafarian M, Rahimi, Anjomrouz M. Impact of herniation level on surgical outcome of microlumbar discectomy. Austin J Orthopade Rheumatol. 2014; 1 (1): 3.
14. Tait MJ, Levy J, Nowell M, Pocock C, Petrik V, Bell BA, et al. Improved outcome after lumbar microdiscectomy in patients shown their excised disc fragments: a prospective, double blind, randomised, controlled trial. J Neurol Neurosurg Psychiatry, 2009; 80 (9): 1044-6.
15. Aichmair A, Du JY, Shue J, Evangelisti G, Sama AA, Hughes AP, et al. Microdiscectomy for the treatment of lumbar disc herniation: an evaluation of reoperations and long-term outcomes. Evid Based Spine Care J. 2014; 5 (2): 77-86.
16. El-Kader HE. Lumbar disc herniation in adolescents. Clinical experience and surgical outcome. Egyptian J Neurosurg. 2014; 29 (4): 45-50.
17. Sharma MK, Chichanovskaya LV, Shlemsky VA, Petrukhina E. A comprehensive study of outcome after lumber discectomy for lumbar degenerative spine disease at 6 months post-operative period. Open J Neurosurg. 2013; 6: 1-5.
18. Paradiso R, Alexandre A. The different outcomes of patients with disc herniation treated either by microdiscectomy, or by intradiscal ozone injection. Acta Neurochir Suppl. 2005; 92: 139-42.
Published
2019-06-04
Section
Original Article