Surgical Outcomes of Lumbar Spine Procedures; A Prospective Cohort Study in A Tertiary Care Hospital
DOI:
https://doi.org/10.36552/pjns.v29i1.973Abstract
Objective: To know about the surgical results of lumbar spine procedures performed at MTI Hayatabad Medical Complex and Naseer Teaching Hospital Peshawar.
Material and Methods: This prospective cohort study was carried out in the Neurosurgery department at Nasser Teaching Hospital and MTI Hayatabad Medical Complex, from 1st January 2020 to 25th January 2024. We included 267 patients, consisting of both genders, that is, male and female, with the ages ranging from 17 years to 72 years. The Lumbar spine procedures included in our study were; Laminectomy, Partial laminectomy, Discectomy, Right and Left Fenestration, all the rest of the lumbar spine procedures were excluded. The surgical outcome was assessed using a VAS score for grading pain before the procedure and 6 months after the procedure.
Results: The study revealed that the average age of the patients was 41.87 years, with a standard deviation of 12.827 years. The youngest patient was 17 years old, and the oldest was 72 years. In terms of gender distribution, males accounted for 46.1% (123 out of 267), while females made up 53.9% (144 out of 267). The most commonly affected site was the L4-L5 level, observed in 133 patients (49.8%), followed by the L5-S1 level, which affected 105 patients (39.3%).
Conclusion: The results indicate that such surgeries can significantly improve patient outcomes in terms of pain relief.
References
Weiss AJ, Elixhauser A, Barrett ML, et al. Opioid-Related Inpatient Stays and Emergency Department Visits by State, 2009–2014. In: Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Agency for Healthcare Research and Quality (US), Rockville (MD); 2006. PMID: 28682575.
Goz V, Rane A, Abtahi AM, Lawrence BD, Brodke DS, Spiker WR. Geographic variations in the cost of spine surgery. Spine. 2015;40(17):1380-9.
DOI: 10.1097/BRS.0000000000001022
Kim S, Hedjri SM, Coyte PC, Rampersaud YR. Cost-utility of lumbar decompression with or without fusion for patients with symptomatic degenerative lumbar spondylolisthesis. The Spine Journal. 2012;12(1):44-54.
DOI: 10.1016/j.spinee.2011.10.004
Kazberouk A, Sagy I, Novack V, McGuire K. Understanding the extent and drivers of interphysician cost variation for spine procedures. Spine. 2016;41(13):1111-7.
DOI: 10.1097/BRS.0000000000001449
Khan MI, Munir A, Aziz S, Ali H, Shah SM, Nasir F. Short Term Clinical Outcomes in Spine Surgeries. A Descriptive Cross-Sectional Study in a Tertiary Care Hospital. Pakistan Journal of Medical & Health Sciences. 2023;17(05):613-.
DOI: 10.53350/pjmhs2023175613
Jordon J, Konstantinou K, O'Dowd J. Herniated lumbar disc. BMJ clinical evidence. 2009;2009. PMCID: PMC2907819
Amin RM, Andrade NS, Neuman BJ. Lumbar disc herniation. Current reviews in musculoskeletal medicine. 2017;10:507-16.
DOI: 10.1007/s12178-017-9441-4
Fjeld OR, Grøvle L, Helgeland J, Småstuen MC, Solberg TK, Zwart JA, Grotle M. Complications, reoperations, readmissions, and length of hospital stay in 34 639 surgical cases of lumbar disc herniation. The bone & joint journal. 2019;101(4): 470-7.
Doi: 10.1302/0301-620X.101B4.BJJ-2018-1184.R1
Waxenbaum JA, Reddy V, Futterman B. Anatomy, Back, Intervertebral Discs. 2023 Dec 9. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. PMID: 29262063.
Schoenfeld AJ, Weiner BK. Treatment of lumbar disc herniation: Evidence-based practice. International journal of general medicine. 2010:209-14. Doi: 10.2147/ijgm.s12270
Silvinato A, Simões RS, Buzzini RF, Bernardo WM. Lumbar herniated disc treatment with percutaneous hydrodiscectomy. Revista da Associação Médica Brasileira. 2018; 64:778-82.
DOI: 10.1590/1806-9282.64.09.778
Harper R, Klineberg E. The evidence-based approach for surgical complications in the treatment of lumbar disc herniation. International Orthopaedics. 2019; 43:975-80.
DOI: 10.1007/s00264-018-4255-6
Dydyk AM, Ngnitewe Massa R, Mesfin FB. Disc Herniation. [Updated 2023 Jan 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK441822/
Estefan M, Munakomi S, Camino Willhuber GO. Laminectomy. [Updated 2023 Aug 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK542274/
Munting E, Röder C, Sobottke R, Dietrich D, Aghayev E, Spine Tango Contributors. Patient outcomes after laminotomy, hemilaminectomy, laminectomy and laminectomy with instrumented fusion for spinal canal stenosis: a propensity score-based study from the Spine Tango registry. European spine journal. 2015;24:358-68.
DOI: 10.1007/s00586-014-3349-0
Wong AP, Smith ZA, Lall RR, Bresnahan LE, Fessler RG. The micro endoscopic decompression of lumbar stenosis: a review of the current literature and clinical results. Minimally Invasive Surgery. 2012;2012. Doi: 10.1155/2012/325095
Anwar T, Rehman MA, Ahmad UT, Anwer A, Wahab A, Tariq QT. Comparing Mean Post-Operative Back Pain Score between Hemilaminectomy and Conventional Laminectomy in Patients of Lumbar Stenosis. Pakistan Journal of Neurological Surgery. 2021;25(2):207-14. DOI: 10.36552/pjns.v25i2.555
Haddadi K, Ganjeh Qazvini HR. Outcome after surgery of lumbar spinal stenosis: a randomized comparison of bilateral laminotomy, trumpet laminectomy, and conventional laminectomy. Frontiers in surgery. 2016; 3:19.
DOI: 10.3389/fsurg.2016.00019
SHin MH, KiM JS, Ryu KS, HuR JW. Bilateral decompression via microscopic tubular crossing laminotomy (MTCL) for lumbar spinal stenosis: technique and early surgical result. Neurologia medico-chirurgica. 2015;55(7):570-7.
DOI: 10.2176/nmc.oa.2014-0251
Moisi M, Fisahn C, Tkachenko L, Tubbs RS, Ginat D, Grunert P, Jeyamohan S, Reintjes S, Ajayi O, Page J, Oskouian RJ. Unilateral laminotomy with bilateral spinal canal decompression for lumbar stenosis: a technical note. Cureus. 2016;8(5).
DOI: 10.7759/cureus.623
Zahid H, Ali I, Choudhary N, Rashid J, Mehmood K. Microscopic Discectomy Outcomes in Lumbar Disc Herniation Patients. Pakistan Journal of Neurological Surgery. 2019;23(2):142-5.
Hermansen E, Austevoll IM, Hellum C, Storheim K, Myklebust TÅ, Aaen J, Banitalebi H, Anvar M, Rekeland F, Brox JI, Franssen E, Weber C, Solberg TK, Furunes H, Grundnes O, Brisby H, Indrekvam K. Comparison of 3 Different Minimally Invasive Surgical Techniques for Lumbar Spinal Stenosis: A Randomized Clinical Trial. JAMA Netw Open. 2022;5(3): e224291. PMID: 35344046; PMCID: PMC8961320. DOI: 10.1001/jamanetworkopen.2022.4291
Shih CM, Hsu CE, Chen KH, Pan CC, Lee CH. Surgical outcomes of anterior lumbar interbody fusion in revision lumbar interbody fusion surgery. J Orthop Surg Res. 2023;18(1): 497.
PMID: 37443066; PMCID: PMC10339485.
Doi: 10.1186/s13018-023-03972-6
Qian MP, Dong MR, Li J, Kang F. The duration of chronic low back pain is associated with acute postoperative pain intensity in lumbar fusion surgery: a prospective observational study. BMC anesthesiology. 2022;22(1):129.
DOI: 10.1186/s12871-022-01674-w
Kanaan SF, Melton BL, Waitman LR, Simpson MH, Sharma NK. The effect of age and gender on acute postoperative pain and function following lumbar spine surgeries. Physiotherapy Research International. 2021:e1888. DOI: 10.1002/pri.1888
Amoroso K, Okano I, Sarin M, Hughes AP, Zelenty WD, Shue J, Sama AA, Cammisa FP, Girardi FP, Soffin EM. Comparative effectiveness of anesthetic technique on outcomes after lumbar spine surgery: a retrospective propensity score-matched analysis of the National Surgical Quality Improvement Program, 2009–2019. Regional Anesthesia & Pain Medicine. 2023;343-8.
DOI: 10.1136/RAPM-2022-104098
Jitpakdee K, Liu Y, Kim YJ, Kotheeranurak V, Kim JS. Factors associated with incomplete clinical improvement in patients undergoing transforaminal endoscopic lumbar discectomy for lumbar disc herniation. European Spine Journal. 2023;32(8):2700-8.
DOI: 10.1007/s00586-023-07636-1
Park, D.Y., Upfill-Brown, A., Curtin, N, et al. Clinical outcomes and complications after biportal endoscopic spine surgery: a comprehensive systematic review and meta-analysis of 3673 cases. Eur Spine J 2023;32.
Doi: 10.1007/S00586-023-07701-9
Halicka M, Wilby M, Duarte R, Brown C. Predicting patient-reported outcomes following lumbar spine surgery: development and external validation of multivariable prediction models. BMC Musculoskeletal Disorders. 2023.
DOI: 10.1186/s12891-023-06446-2
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