Endoscopic Lumbar Discectomy Using Side-Viewing Conical Working Tube: An Institutional Experience

Objective The paradigm of surgical therapy for spinal disease especially for lumbar disc herniation (LDH) has gradually shifted from the traditional open surgeries to minimal invasive spinal surgeries. Endoscopic discectomy has been performed widely using various devices and techniques. In this study we present our experience of endoscopic discectomy using a unique device with separate side-viewing channel. Methods Twenty-six patients with LDH treated between March 2015 and April 2018 using the unique conical working tube with separate side-viewing endoscopic channel have been retrospectively analyzed. Their preoperative and postoperative Oswestry Disability Index (ODI) and Macnab scores were used to evaluate the outcome with a mean follow-up of 37.04 months. Results There were 18 males and 8 females with age ranging from 19 to 72 years (mean, 38.4 years). The follow-up ranged from 25 to 60 months with mean of 37.04 months. The mean preoperative ODI score was 72.4, which decreased to a mean of 7.6 and the outcome evaluated by Macnab criteria was 65.3% excellent, 19.2% good, 11.5% fair, and 3.8% poor. One patient underwent second surgery. None of the patients had to change their occupation postoperatively. Complications that occurred were dural tear in one patient and transient foot paresis in one, which improved spontaneously. Conclusion Endoscopic discectomy using conical working tube is a safe and effective technique for lumbar disc prolapse. The long-term results are comparable to the conventional techniques.

Correlation of Chronic Back Pain and Hyperuricemia, Our Hospital Experience

Objective: This study aimed to analyze the prevalence of hyperuricemia in individuals with chronic low back pain. Methodology: It was a descriptive cross-sectional study performed between January 2021 to June 2021 in Medicine department of Bilawal Medical College LUMHS Jamshoro Pakistan. Patients between the age of 18 to 65 years have been investigated. Data was collected using a designed questionnaire. X-rays and Magnetic Resonance Imaging (MRI) of the lumbosacral spine were used to evaluate any discrepancies associated with low back pain. The levels of uric acid in the blood were measured and documented. Results: Out of 88 patients with chronic low back pain, 22 (25%) reported hyperuricemia. There was no significant difference in uric acid levels between men and women (P>0.05). We observed that 86.36 %t (n=19) patients with elevated serum uric acid levels also experienced joint pain. Further radiological examination revealed lumbar disc prolapse in 72.7 % (n=16). We found that in 95.45% of the patients, disc space narrowing was present. Conclusion: Regardless of gender, one in four people with low back pain had hyperuricemia. Patients with low back pain have varying occupational and co-morbidities. Hypouricemia appears to be associated with lumbar disc prolapse and lumbar vertebral joint space constriction. This reveals that hyperuricemia aggravates degenerative spondylolisthesis.

Lumbar Disc Herniations in Children. A Five-Year Single Center Experience

Lumbar disc herniations represent one of the most common complications of degenerative disc disease in adults and have a favorable outcome with surgery. In children, on the other hand, disc prolapse is a relatively rare pathologic entity mandating cautious multimodal management. This paper presents the five-year long experience of a single pediatric neurosurgical unit and our management strategy for children diagnosed with lumbar disc prolapse.

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

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.