Surgical Outcome of Lumbar Disc Surgery in 250 Patients
Abstract
Objectives: To study the outcome of patients with Lumbar Disc Herniation managed surgically by fenestration discectomy and laminectomy.
Study design: Retrospective study.
Materials and Methods: This study was conducted in Neurosurgery Department, Hayatabad Medical Complex, Peshawar from Jan, 2006 to December, 2007 with 6 months follow up. Total numbers of patients were 250. Data was collected with the help of performa containing name, age, sex of patient along-with signs and symptoms, investigation, complications and follow up findings.
Results: We included patients of both gender with age ranging from 18 to 60 years with mean age 39 years including 147 (58.8%) male and 103 (41.2%) female ratio 1.42:1, 250 patients were operated upon for Lumbar Disc Herniation. 06 (2.4%) patients had superficial wound infection, 06 (2.4%)had dural tear with 2 (0.8%) postop CSF leak, 04 (1.6%) patients suffered discitis and 14 (5.6%) patients had reherniation of discs at same operative level. Patients with recurrent disc herniation, Disc herniation with spondylolisthesis, patients below 18 years and above 60 years and patient with Disc Prolapse above L3-4 were excluded from the study.
Conclusion: Lumbar disc surgery is safe and effective procedure in good and experienced surgical hands by which pain and neurological deficit of patients can be reduced and prevented giving them good quality of life. Proper patient selection is imperative in achieving successful outcome. By strict selection criteria we can reduce the complications of this procedure.
Key words: Lumbar Disc Herniation, Discectomy, Laminectomy.
References
Jeffery N, Katz, MD, MSc. Lumbar disc disorders and low-back pain: Socioeconomic factors and consequen-ces. Journal of bone and joint surgery (American) 2006; 88: 21-24. doi: 10.2106/JBJS.E.01273.
Huw B, Griffith. Pit falls in the management of lumbar disc prolapse. Prog Neurol Surg. Basel, Karger, 1990; 13: 154-180.
Atlas SJ, Deyo RA, Keller RB; the Maine lumbar spine study, part II, one year outcome of surgical and non sur-gical management of sciatica. Spine 1996, 21: 1777-86.
Knoeller, Stefan M. MD, Seifreid, Christian can. Med. Historical Perspective: History of Spinal Surgery. Spine, 2000 Nov 1; 25 (21): 2838-43.
Deen H. G., Fenton D.S., Lamer T. J. Minimally inva-sive procedures for disorders of the lumbar spine. Mayo Clin. Proc., 2003 Oct; 78 (10): 1249-5.
Mixter W. J., Barr J. S. Rupture of the intervertebral disc with involvement of the spinal canal. N. Engl. J. Med., 1934; 211: 210-14.
Barr J. S. Intervertebral disc lesion as cause of sciatica. Br. Med. J., 1938; 4067: 1247.
Heary R.F. Intradiscal electrothermal annuloplasty: the IDET procedure. J. Spinal Disord., 2001 Aug; 14 (4): 353-60.
Hijikata S. A. A method percutaneous nuclear extrac-tion. Journal of Toden Hospital, 1975; 5: 39.
Onik G., Helms C.A., Ginsburg L., Hoaglund F. T., Morris J. Percutaneous Lumbar Diskectomy using a new aspiration probe. A. J. R., Am. J. Roentgenol., 1985 Jun.; 144 (6): 1137-40.
Maroon J. C., Onik G., Sternau L. Percutaneous Auto-mated Discectomy: A new approach to lumbar surgery. Clin. Ortho. Rel. Res., 1989 Jan., 238: 64-70.
Jansson KA, Nemech G, Granach F, Blomqvist P: Sur-gery for herniation of a lumbar disc in Sweden between 1987 and 1999. An Analysis of 27, 576 operations; J Bone Joint Surg; Aug, 2004; 86 (6): 841-47.
Jonson B, Stromq vist B: The straight leg raising test and the severity of symptoms in lumbar disc herniation. A preoperative and postoperative evaluation. Spine 1995; 20 (I): 27-30.
Debusscher F, Troussel S. direct repair of defects in lumbar spondylosis with a new pedicle screw hook fixation: clinical, functional and Ct-assessed study. Eur Spine J. 2007 Oct; 16(10): 1650-8. Epub 2007 May 23.
Fisher C, Noonan V, Bishop P, Boyd M, Fairholm D, Wing P, et al: Outcome evaluation of the operative management of lumbar disc herniatino causing sciatica; J Neurosurg (Spine 4) 2004; 100: 317-24.
Kudret Tureyen: One level one sided lumbar disc sur-gery with and without microscopic assistance: 1 year outcome in 114 conservative patients. J Neurosurg (Spine 3) 2003; 99: 247-250.
AM Thomas and F Afshar. The microsurgical treatment of lumbar disc protrusion. Follow-up of 60 cases. Jour-nal of bone and joint surgery – British volume 1987, Vol 69-B, Issue 5, 696-698.
Mariconda M, Galasso, Beneduce T, Volpicelli R, Della Rotonda G, Secondulfo V, Lmbimbo L, MilanoC. Minimum 25-year outcome of standard discectomy for lumbar disc herniation. Journal of bone and joint sur-gery – British volume Jun 2005, Vol 88-B, Issue SUPP_I, 152-153.
Malter AD, McNeney B, Loeser JD, Deyo RA. 5-year reoperation rates after different types of lumbar spine surgery. Spine. 1998 Apr 1;23(7): 814-20.
B.M. Jolles, F. Porchet, N. Theumann. Surgical treat-ment of lumbar spinal stenosis. Journal of bone and joint surgery – British volume Sep 2001, Vol 83-B, No. 7, 949-953.
Siddiq M, Ali N, Jan Wa, Dil R: Surgical management of lumbar disc herniation by standard leminectomy in a periphery hospital; an experience with 64 patients. J Postgrad Med Inst: Jan 2003; 17 (I): 20-25.
Eugene J, Carragee, MD, Micheal Y, Han, MD, Patrik W, Suen, MD, David Kim, MD. Clinical outcomes after lumbar discectomy for sciatica: The effects of fragment type and anular competence. Journal of bone and joint surgery (American) 2003 85: 102-108.
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