Roles of Sociodemographic Characteristics in Determining Neurological Outcomes in Patients with Lumbar Disc Herniation after Microdiscectomy

Kiran Niraula, Muhammad Irfan, Azam Niaz


Introduction: Socio-demographic characteristics like age, gender, occupation has important role in causation of lumbar disc herniation which may even affect their recovery after the surgery. We want to explore the difference in improvement in Neurological status in terms of difference in socio-demographic characteristics of patients.
Objective: To find variation in improvement in Neurological status in post microdiscectomy lumbar disc herniation patient stratified in terms of socio-demographic characteristics.
Material and Methods: A Quasi experimental study comprising 70 consecutive cases though non-probability purposive sampling technique of both the sexes admitted in Neurosurgery department, Mayo Hospital operated for the 1st time for any disc pathology with no other spinal lesions giving consent themselves or though legal guardians was conducted. Pain for leg and back was measured pre and post-operatively was done by VAS which had 42 days of follow up. Standard Neurological examinations were conducted pertaining to muscle power (by MRC), sensory status and SLR test pre and post-operatively. Variables according to their nature were expressed in the form of Mean ± SD, Median (Range) and Frequency (percentage). Comparisons between categorical and continuous variables were done with the help of t test and one way ANOVA and comparison between both categorical variables was done with the help of chi square test in SPSS version 15.
Results: Out of 70 patients 74% were male and 26% were females. Mean ± SD of patients was 37.6 ± 13.0 years. Majority were Laborers after housewives. Illiterates, Poor lifting techniques were the most common charac-teristics in the respective headings of education and employment. Most common level of disc herniation was L4-L5, L5-S1 level (96%) where Prolapse and extrusion were most common MRI findings. Improvement in motor power, sensory status was not dependent on any of socio-demographic characteristics. Improvement on SLR was associated with male genders on 1st (p = 0.03) as well as 7th, 21st and 42nd PODs (p = 0.001).
Conclusion: Except gender in SLR value improvement, no other socio-demographic characteristics alter the improvement status in LDH patient after microdiscectomy.
Key words: LDH, Pattern of improvement, MRC, Sensation, SLR.

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Osterman H, Seitsalo S, Karppinen J, et al. Effective-ness of microdiscectomy for lumbar disc herniation: a randomized controlled trial with 2 years of follow-up. Spine, 2006; 31: 2409–14.

Lau D, Han SJ, Lee JG, Lu DC, Chou D. Minimally invasive compared to open microdiscectomy for lumbar disc herniation. J Clin Neurosci. 2011; 18 (1): 81-4.

German JW, Adamo MA, Hoppenot RG, et al. Peri-operative results following lumbar discectomy: compa-rison of minimally invasive discectomy and standard microdiscectomy. Neurosurg Focus, 2008; 25: E20.

Chi JH, Dhall SS, Kanter AS, et al. The mini-open tra-nspedicular thoracic discectomy: surgical technique and assessment. Neurosurg Focus, 2008; 25: E5.

Righesso O, Falavigna A, Avanzi O. Comparison of open discectomy with microendoscopic discectomy in lumbar disc herniations: results of a randomized con-trolled trial. Neurosurg. 2007; 61: 545–9.

Nowitzke AM. Assessment of the learning curve for lumbar microendoscopic discectomy. Neurosurg. 2005; 56: 755–62.

Wu X, Zhuang S, Mao Z, et al. Microendoscopic dis-cectomy for lumbar disc herniation: surgical technique and outcome in 873 consecutive cases. Spine, 2006; 31: 2689–94.

Harrington JF, French P. Open versus minimally inva-sive lumbar microdiscectomy: comparison of operative times, length of hospital stay, narcotic use and compli-cations. Minim Invasive Neurosurg. 2008; 51: 30–5.

Cole JS, Jackson TR. Minimally invasive lumbar dis-cectomy in obese patients. Neurosurg. 2007; 61: 539–44.

Ryang YM, Oertel MF, Mayfrank L, et al. Standard open microdiscectomy versus minimal access trocar microdiscectomy: results of a prospective randomized study. Neurosurg. 2008; 61: 174–82.

Arts MP, Peul WC, Brand R, et al. Cost-effectiveness of microendoscopic discectomy versus conventional open discectomy in the treatment of lumbar disc her-niation: a prospective randomized controlled trial. BMC Musculoskelet Disord. 2006; 7: 42.

Postacchini F, Giannicola G, Cinott Gi. Recovery of motor deficits after microdiscectomy for lumbar disc herniation. J Bone Joint Surg. 2002; 84: 1040-5.

Leeuw M, Goossens MEJB, Linton SJ, Crombez G, Boersma K, Vlaeyen JWS. The fear-avoidance model of musculoskeletal pain: current state of scientific evi-dence. Journal of Behavioral Medicine, 2007; 30 (1): 77-94.

Lundberg M, Frennered K, Hagg O, Styf J. The impact of fear-avoidance model variables on disability in pati-ents with specific or nonspecific chronic low back pain. Spine. Sep. 1 2011; 36 (19): 1547-1553.

Celestin J, Edwards RR, Jamison RN. Pretreatment psy-chosocial variables as predictors of outcomes following lumbar surgery and spinal cord stimulation: a systema-tic review and literature synthesis. Pain Medicine. May-Jun. 2009; 10 (4): 639-653.

Deville WL, van der Windt DA, Dzaferagic A, Beze-mer PD, Bouter LM. The test of Lasegue: systematic review of the accuracy in diagnosing herniated discs. Spine, 2000; 25 (9): 1140-1147.


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