Lumbar Disc Herniation, Clinical Analysis Muzaffarabad, AK
Keywords:
Prolapsed lumber disc, backache, fenestration discectomy.Abstract
Objective: Analysis of different variables in patients operated for lumbar disc prolapsed.
Materials and Method:
Study design: Observational study.
Sample size: Twelve hundred forty eight consecutive patients operated for lumbar disc herniation.
Settings: Abbas Institute of Medical and Health Sciences.
Duration: The study duration was four years from January 2005 to December 2009.
Inclusion criteria: Patients irrespective of age and sex with lumbar disc herniation having. Failed conservative treatment for 3 weeks. Intractable pain or impending neurological deficit.
Exclusion criteria: Spinal stenosis. Spinal tumors. Spinal tuberculosis. Spondylolysthesis. Psychological problems.
Results: Out of 1248 patients 812 were male and 416 were female with male to female ratio of 2:1. The age ranged from 20 to 60. Majority 672 (56%) of patients were from Muzzafrabad and its suburbs. Straight leg raising test was impaired in1180 cases. The ratio between contained and ruptured disc was 3:1. About 44.9% of patients (560) had left lateral disc prolapse, while right sided in 29.5% cases and bilateral in 25.6% cases. The common level affected was L4-L5 in 900 (72.1%) patient. Fenestration and discectomy was suitable in 900 patients, 232 patients had Hemilaminectomy and in 116 laminectomy was carried out. The removed disc tissue was sent for histopathology in all cases. Out of which three were reported as tuberculosis, two metastasis and two plamacytoma. Forty patients developed discitis postoperatively.
Conclusion: From this study we conclude that lumber disc herniation is common in male gender in 4th decade. Left lateral disc at L4-L5 level is involved in the majority of patients. Sciatica with backache and impaired straight leg raising test are important clinical features. Contained disc is more common than ruptured discs. Minimal invasive procedures like fenestration and disectomy gives good results. It is also concluded that all disc material should be sent for histopathology examination to over look unusual pathologies
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