Postoperative Wound Pain and Hospital Stay in Patients of Open Lumbar Discectomy (OLD) Versus Endoscopic Lumbar Discectomy (ELD) in Lumbar Disc Herniation (LDH)

Authors

  • SYED SHAHZAD HUSSAIN Department of Neurosurgery, Jinnah Hospital, Lahore
  • USMAN AHMED KAMBOOH Department of Neurosurgery, Jinnah Hospital, Lahore
  • ASIF RAZA Department of Neurosurgery, Jinnah Hospital, Lahore
  • ADIL AMIN Department of Neurosurgery, Jinnah Hospital, Lahore
  • SAMAN SHAHID 2Department of Sciences & Humanities, National University of Computer & Emerging Sciences (NUCES), Foundation for Advancement of Science & Technology (FAST), Lahore
  • NAVEED ASHRAF Department of Neurosurgery, Jinnah Hospital, Lahore

DOI:

https://doi.org/10.36552/pjns.v24i1.414

Keywords:

Open Lumbar Discectomy, Endoscopic Lumbar Discectomy, Visual Analogue Score, Lumbar Disc Herniation, Left/Right Sided Prolapsed Paracentral Disc

Abstract

Background: Endoscopic lumbar discectomy is also beneficial regarding relieving wound pain, less hospital stay and smaller incisions. We compared visual analog scores (VAS) and hospital stay in patients treated with either endoscopic lumbar discectomy or open lumbar discectomy postoperatively.
Material and Methods: Half patients underwent open lumbar discectomy – OLD (group A) and half operated with endoscopic lumbar discectomy – ELD (group B). The pain was quantified through visual analog score (VAS) observation in all patients. A preoperative medical management included prescribing a combination of an analgesic and a muscle relaxant along with physiotherapy with an avoidance of lifting heavy loads. Mann- Whitney (U) tests were applied for the comparison of postoperative VAS and hospital stay between groups.
Results: 85% patients were having left sided prolapsed paracentral disc, and 15% were having right sided prolapsed paracentral disc. The mean postoperative VAS was 4 in patients treated with ELD and it was 1.32 in patients treated with OLD. The mean hospital stay was 1.5 days in ELD treatment, whereas, it was 2.5 days in OLD treatment. A significant difference (p=0.037) was found in the comparison of mean post-operative VAS between two vertebral levels (i.e., L4-L5 & L5-S1). The post-operative VAS and hospital stay (days) in ELD group were statistically significantly higher than the OLD group (p values 0.000).
Conclusion: ELD procedure was effective as compared to open lumbar discectomy in terms of postoperative wound site pain and hospital stay. Endoscopic Lumbar discectomy is a minimally invasive procedure for discectomy.

References

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2. Peul WC, Van Houwelingen HC, van den Hout WB, et al. Surgery versus prolonged conservative treatment for sciatica. New Engl J Med. 2007; 356 (22) :2245-56.
3. Righesso O, Falavigna A, Avanzi O. Comparison of open discectomy with microendoscopic discectomy in lumbar disc herniations: results of a randomized controlled trial. Neurosurg. 2007; 61 (3): 545-9.
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5. Wahlström J, Burström L, Nilsson T, et al. Risk factors for hospitalization due to lumbar disc disease. Spine, 2012; 37 (15): 1334-9

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Published

2020-04-11

Issue

Vol. 24 No. 1 (2020): January-March

Section

Original Articles

License

The work published by PJNS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Copyrights on any open access article published by Pakistan Journal of Neurological Surgery are retained by the author(s).