An assessment of Discectomy Surgery on Prolapsed Lumbar Intervertebral Disc.

Abstract

Background: Basically, human backbone or spinal column is of a chain of bones also known as vertebrae. Spinal cord runs through the spinal column. Lumbar discectomy is a type of surgery to fix a disc in the lower back portion of human body. This surgery uses smaller cuts (incisions) than an open lumbar discectomy. We have very few proved data regarding the effectiveness of discectomy surgery on prolapsed lumbar intervertebral disc.

Aim of the study: The aim of this study was to assess the role of discectomy surgery on prolapsed lumbar intervertebral disc.

Methods: This was a prospective observational study which was conducted at the Department of Orthopedics Surgery in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period from January 2017 to December 2017. In total 38 patients with low back pain selected for discectomy surgery on prolapsed lumbar intervertebral disc were enrolled as the study population. This study was approved by the ethical committee of the mentioned hospital. Proper written consents were taken from all the participants before starting data collection. A pre-designed questionnaire was used in patent data collection. Radicular pain was observed by visual analogue score and disability status was done by using Oswestry disability index. By using modified Macnab criteria, outcome of the surgery was determined. All data were processed, analyzed and disseminated by MS Office and SPSS version as per need.

Result: In our study as postoperative complication dural tear, superficial wound infection and foot drop were observed in 57.14% (Highest), 28.57% and 14.29% (Lowest) participants respectively. In analyzing radicular pain among the participants, we observed that VAS score had been reduced to 1.6±1.2 from 7.2±5.4 within one year of surgery which was 2.7±1.3 at immediate postoperative period. On the other hand, in analyzing Disability status among the participants we observed that, ODI index had been reduced to 10±1 from 64±8 within one year of surgery which was 17±6 at immediate postoperative period. According to the Modified Macnab Criteria in analyzing the final outcome among the participants we observed 52.63%, 39.47%, 5.26% and 2.63% participants got ‘Excellent’ (Highest), ‘Good’, ‘Fair’ and ‘Poor’ (Lowest) results respectively.

Conclusion: In terms of reduction of pain, complication and disability scores it was noted that, in the surgery of prolapsed lumbar intervertebral disc the surgical outcome after one year period of discectomy is quite satisfactory. Considering the cost effectiveness and short treatment duration this surgical method may consider as the choice of method for treating patients with prolapsed lumbar intervertebral disc.