scholarly journals Functional outcome of microscopic lumbar discectomy for the treatment of lumbar disc prolapse

2018 ◽  
Vol 4 (3) ◽  
pp. 389
Author(s):  
Ansari Ishtyaque Abdul Aziz ◽  
Ansari Muqtadeer Abdul Aziz
Keyword(s):  
Back Pain ◽  
Lumbar Disc ◽  
Japanese Orthopaedic Association ◽  
Significant Proportion ◽  
Scientific Basis ◽  
Radicular Pain ◽  
Lumbar Discectomy ◽  
Leg Pain ◽  
Disc Prolapse ◽  
Lumbar Disc Prolapse

<p class="abstract"><strong>Background:</strong> Back pain constitutes significant proportion of orthopaedic practitioner OPD. Lumbar disc prolapse constitutes important cause of back pain with radiculopathic leg pain. Different techniques have evolved to treat this disorder non-operatively and operatively. Operative techniques vary a lot in the field of spine surgery depending on the surgeon, institute, infrastructure and cost. We present simple, cost effective, cosmetic, operative technique with scientific basis which gives better visualization for decompression of nerve root in this paper called microscopic lumbar discectomy (MLD).</p><p class="abstract"><strong>Methods:</strong> On the basis of inclusion and exclusion criteria 26 patients were operated by microscopic lumbar discectomy (MLD) technique. All the patients were followed up at the interval of 1 month, 3 months and 6 months and assessment was done of subjective and objective findings with Japanese orthopaedic association (JOA) score and rate of improvement (RI) was calculated. Out of 26 patients 18 were men and 8 were women. Age ranges from 28 years to 72 years. Mean age being 47.8 years.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 26 patients at the time of discharge, 20 patients (87.5%) could walk independently without any aid and without any radicular pain. In most of the patients 19 (73.07%) sciatica improved immediately. The pre-operative mean±SD (SE) JOA score was 8.346±0.85 (0.169) which improved to 11.807±0.694 (0.136) after 1 month and 13.19±0.895 (0.175) after 6 months.</p><p class="abstract"><strong>Conclusions:</strong> Excellent to good results and improvement can be achieved surgically, economically and cosmetically by microscopic lumbar discectomy technique in the spine lumbar disc prolapse patients at many spine centre with cosmesis, good results and rehabilitation of the patient.</p><p class="abstract"> </p>

scholarly journals Functional outcome of patients undergoing lumbar discectomy

2018 ◽  
Vol 4 (3) ◽  
pp. 514
Author(s):  
Harpreet Singh ◽  
Parth B. Bhavsar ◽  
Ankit Singh ◽  
Saurin Patel
Keyword(s):  
Functional Outcome ◽  
Lumbar Disc ◽  
Subjective Evaluation ◽  
Lumbar Discectomy ◽  
Intervertebral Disc Herniation ◽  
Disc Prolapse ◽  
Duration Of Symptoms ◽  
Lumbar Disc Prolapse ◽  
Lumbar Intervertebral Disc Herniation

<p class="abstract"><strong>Background:</strong> Sciatica resulting from a lumbar intervertebral disc herniation is the most common cause of radicular leg pain in adult working population. It can be treated with both conservative and operative methods. In our study, surgical treatment of lumbar disc prolapse has been done by open discectomy. We wish to assess the outcome of surgery in patients with lumbar disc prolapse undergoing lumbar discectomy.</p><p class="abstract"><strong>Methods:</strong> 40 patients were included in this study and were followed up for up to 1 year postoperatively. We assessed the outcome of each patient with ODI and VAS post-operatively and on follow-up at 3 weeks, 6 months and 1 year. Subjective evaluation of the patient’s satisfaction at the final follow-up was also done.<strong></strong></p><p class="abstract"><strong>Results:</strong> We found that males had higher incidence of PIVD with an average duration of symptoms before surgery about 8.62 months. Left side was most involved and level l4-l5 was most involved level. The mean ODI and VAS score pre-operatively were 26.85±4.20 and 7.73±0.88 respectively, which changed to 4.48±5.15 and 1.70±1.57, respectively at 1 year post-operative follow-up. These were statistically highly significant. Most of the patients (34) gave a subjective evaluation as excellent at 1 year follow-up.</p><p class="abstract"><strong>Conclusions:</strong> Our study established that open discectomy has a satisfactory functional outcome and leads to a significant improvement in the patients’ quality of life.</p>

Percutaneous Endoscopic Lumbar Discectomy for Treating Cauda Equina Syndrome Due To Lumbar Disc Herniation

2021 ◽  
Author(s):  
Hai-Chao He ◽  
Xiao-qiang LV ◽  
Yong-Jin Zhang
Keyword(s):  
Back Pain ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Cauda Equina Syndrome ◽  
Lumbar Disc ◽  
Cauda Equina ◽  
Lumbar Discectomy ◽  
Leg Pain ◽  
Endoscopic Lumbar Discectomy

Abstract Background In recent decades, endoscopic techniques to treat lumbar disc herniation (LDH) have gained popularity in clinical practice. However, there is little literature on the use of percutaneous endoscopic lumbar discectomy (PELD) to treat cauda equina syndrome (CES) due to LDH. This study aims to evaluate the feasibility and clinical efficacy of PELD for treating CES caused by disc herniation, and as well as to report some technical strategies. Methods Between October 2012 and April 2018, 15 patients with CES caused by LDH at the early and intermediate stages of Shi’s classification were selected as the subjects of study, and underwent PELD. All patients were followed up for at least two years. The patients’ back pain and leg pain were evaluated using visual analogue scale (VAS) scores and the Oswestry Disability Index (ODI). Patient satisfaction was evaluated using the MacNab outcome scale. Clinical outcomes were measured preoperatively and at 3 days, 3 months, 6 months and the last follow-up. Results The VAS score for back pain, leg pain and ODI score significantly decreased from preoperatively scores of 6.67 ± 1.05, 7.13 ± 1.19 and 62.0 ± 6.85 respectively, to postoperatively cores of 1.80 ± 0.41, 1.47 ± 0.52 and 12.93 ± 1.03 at the last follow-up postoperatively. These postoperative scores were all significantly different compared with preoperative scores (P < 0.01). According to the modified MacNab outcome scale, 86.67% of these patients had excellent and good outcomes at the final follow-up. Complications included one patient with cerebrospinal fluid leakage and one patient who developed recurrent herniation; the latter patient finally achieved satisfactory results after reoperation. Conclusion PELD could be used as an alternative surgical method for the treatment of CES due to LDH in properly selected cases and appropriate patient selection. However, the operator should pay attention to foraminoplasty to enlarge the working space.

Lumbar Disc Surgery: Results of the Prospective Lumbar Discectomy Study of the Joint Section on Disorders of the Spine and Peripheral Nerves of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons

Neurosurgery ◽  
1991 ◽  
Vol 29 (2) ◽  
pp. 301-308 ◽  
Author(s):  
Joel N. Abramovitz ◽  
Samuel R. Neff
Keyword(s):  
Logistic Regression ◽  
Back Pain ◽  
Lumbar Disc ◽  
Lumbar Discectomy ◽  
Sensory Deficit ◽  
Leg Pain ◽  
Lumbar Disc Surgery ◽  
Stepwise Logistic Regression ◽  
Mechanical Back Pain ◽  
Straight Leg Raise

Abstract The Prospective Lumbar Discectomy Study enrolled 740 patients in a multiphysician, multicenter, consecutive patient protocol to evaluate the indications and efficacy of lumbar discectomy. Five hundred and thirteen patients could be evaluated at 3 months after surgery. Stepwise logistic regression showed that the factors of fraction of pain referred to the back, work-related injury, absence of back pain on straight leg-raise examination, correspondence of leg pain to typical radicular patterns, leg pain on straight leg-raise examination, and reflex asymmetry were independently predictive of good outcome from surgery. Univariate analysis of the cases with different numbers of predictive factors present showed that use of the operating microscope, sensory deficit, central disc bulge, and free disc fragment were correlated with outcome only in subgroups. An analysis of unsatisfactory outcomes showed two patterns: one of failure as a result of mechanical back pain and one of failure as a result of radiculopathy. Factors predictive of outcome did not influence the type of failure, In a stepwise logistic regression analysis, facetectomy and preoperative sensory deficit were associated with increased likelihood of mechanical back pain failure, while preoperative motor deficit was associated with an increased likelihood of radicular failure. The results support several intuitively derived and commonly believed principles of lumbar disc surgery.

scholarly journals Assessment of clinical efficacy of nefopam hydrochloride in lumbar disc prolapse patients in secondary care hospital

2021 ◽  
Vol 9 (7) ◽  
pp. 1935
Author(s):  
Suligeri Samarpana ◽  
Yerukala Chamundeswari ◽  
K. Jagadeesh ◽  
C. Venkatesh ◽  
G. Vinod ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Drug Therapy ◽  
Secondary Care ◽  
Lumbar Disc ◽  
Care Hospital ◽  
Low Back ◽  
Disc Prolapse ◽  
Lumbar Disc Prolapse ◽  
Pain Patients

Background: In this study assessing the efficacy of 30 mg of nefopam hydrochloride in lumbar disc prolapse patients.Methods: This was a prospective observational study. This study was carried out about 6 months in secondary care hospital. 100 patients are involved in this study. Patient documentation forms, visual analogue scale, patient counselling forms are the materials for this study. In this study patients visiting the Hospital with low back pain patients are included in the study. Pregnancy patients and failed back syndrome are excluded in the study. Results: In this study different age groups of patients as follows 21 patients in 20-30 years of age, 31 patients in 30-40 years of age, 37 patients in 40-60 years of age, 11 patients in 60-80 years of age.Percentage of pain relief of Nefopam hydrochloride drug therapy as follows, 23 patients in 10-20%, 16 patients in 20-40%, 38 patients in 40-60%, 16 patients in 60-80%, 7 patients in 80-100%. Assessing pain intensity in no. of patients after nefopam hydrochloride drug therapy are as follows 10patients has no pain, 28patients has mild pain, 34patients moderate pain, 15 patients has severe pain, 13 patients are worst pain.Conclusions: In current study demonstrated that the analgesic efficacies of nefopam hydrochloride in low back pain patients. Nefopam shows better action in mild, moderate, severe and worst pain. Nefopam shows high efficacy.

RECURRENT DISC HERNIATION AND LONG-TERM BACK PAIN AFTER PRIMARY LUMBAR DISCECTOMY

Neurosurgery ◽  
2009 ◽  
Vol 64 (2) ◽  
pp. 338-345 ◽  
Author(s):  
Matthew J. McGirt ◽  
Giannina L. Garcés Ambrossi ◽  
Ghazala Datoo ◽  
Daniel M. Sciubba ◽  
Timothy F. Witham ◽  
...  
Keyword(s):  
Back Pain ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Lumbar Discectomy ◽  
Leg Pain ◽  
Medline Search ◽  
Recurrent Disc Herniation ◽  
Herniated Lumbar Disc ◽  
Short And Long Term

Abstract OBJECTIVE It remains unknown whether aggressive disc removal with curettage or limited removal of disc fragment alone with little disc invasion provides a better outcome for the treatment of lumbar disc herniation with radiculopathy. We reviewed the literature to determine whether outcomes reported after limited discectomy (LD) differed from those reported after aggressive discectomy (AD) with regard to long-term back pain or recurrent disc herniation. METHODS A systematic MEDLINE search was performed to identify all studies published between 1980 and 2007 reporting outcomes after AD or LD for a herniated lumbar disc with radiculopathy. The incidence of short- and long-term recurrent back or leg pain and recurrent disc herniation was assessed from each reported LD or AD cohort and the cumulative incidence compared. RESULTS Fifty-four studies (60 discectomy cohorts) met the inclusion criteria, reporting the outcomes of 13 359 patients after lumbar discectomy (LD, 6135 patients; AD, 7224 patients). The reported incidence of short-term recurrent back or leg pain was similar after LD (mean, 14.5%; range, 7–16%) and AD (mean, 14.1%; range, 6–43%) (P &lt; 0.01). However, more than 2 years after surgery, the reported incidence of recurrent back or leg pain was 2.5-fold less after LD (mean, 11.6%; range, 7–16%) compared with AD (mean, 27.8%; range, 19–37%) (P &lt; 0.0001). The reported incidence of recurrent disc herniation after LD (mean, 7%; range, 2–18%) was greater than that reported after AD (mean, 3.5%; range, 0–9.5%) (P &lt; 0.0001). CONCLUSION Review of the literature demonstrates a greater reported incidence of long-term recurrent back and leg pain after AD but a greater reported incidence of recurrent disc herniation after LD. Prospective, randomized trials are needed to firmly assess this possible difference.

scholarly journals Metrizamide Epidurography

1983 ◽  
Vol 76 (2) ◽  
pp. 126-130 ◽  
Author(s):  
Gordon Hamilton
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Disc ◽  
Diagnostic Techniques ◽  
Water Soluble ◽  
Outpatient Basis ◽  
Low Back ◽  
Disc Prolapse ◽  
Ionic Contrast ◽  
Lumbar Disc Prolapse

The results are reported of lumbar epidurography in 110 patients suffering from low back pain. By using the water-soluble non-ionic contrast metrizamide, it has been possible to perform the examination on an outpatient basis. None of the patients has suffered from headache, nor any other complaint often associated with other diagnostic techniques which involve lumbar puncture. Epidurography is sufficiently accurate to be regarded as the examination of choice in the diagnosis of lumbar disc prolapse.

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