Short Term Clinical Outcome of Micro Lumbar Discectomy in Tertiary Care Center

Background: Minimal invasive open lumbar microdiscectomy has been associated with good success rate and low morbidity. The present study is aimed to evaluate the clinical outcome of patients who underwent open minimal invasive open lumbar microdiscectomy for herniated intervertebral disc. Materials and Methods: This is a prospective observational hospital based study of prolapsed lumbar intervertebral disc operated in the department of neurosurgery at Nobel Medical College Teaching Hospital, Biratnagar, Nepal from January 2018 to June 2021. All patients of lumbar herniated intervertebral disc subjected for surgery were included. Recurrent prolapsed intervertebral disc, Disc surgery requiring stabilization was excluded from the study. During surgery types of prolapsed intervertebral disc, level and operative time were noted. In the post-operative period Visual Analogue Scale was used to assess the change in severity of pain. Duration of hospital stay and the complications occurred were also noted. Results: The mean age of the study population was was 41.50 (±14.56) years ranging from 20 years to 79 years. The commonest lumbar prolapsed intervertebral disc was at L4-L5 level. The mean operative time was 42 minutes excluding the time for anaesthesia preparation. There was statistically significant difference (p<0.001) in pre-operative and post-operative Visual Analogue Scale. Mean duration of hospital stay was 5.58 (1.87) days. Conclusion: A through workup and surgical planning is associated with better outcome avoiding complications in minimal invasive open micro lumbar discectomy.

Effect of Traditional Korean Medicine Treatment Including Acupotomy on the Level of Pain and Quality of Life of Patients with Cervical Herniated Intervertebral Disc: A Retrospective Observational Study

Background: The purpose of this study was to statistically analyze the treatment effect and patient satisfaction of traditional Korean medicine, including acupotomy treatment of cervical herniated intervertebral disc. Methods: This was a retrospective study of 22 patients who received traditional Korean medicine including acupotomy treatment amongst all patients diagnosed with cervical herniated intervertebral discs at the Korean Medicine hospital in Daejeon, Korean, from January 01, 2020 to April 30, 2021. The clinical data from patient medical records were statistically analyzed. Results: The Numeric Rating Scale, the European Quality of Life 5 Dimensions, and the European Quality of Life Visual Analogue Scale questionnaire scores were each compared before and after traditional Korean medicine treatment, including acupotomy, showed significantly improved scores after treatment (p < 0.001). Out of a total of 22 patients, 11 rated the treatment “very satisfactory” (50%), 5 “satisfactory” (22.7%), 5 “indifferent” (22.7%), 1 “unsatisfactory” (4.5%), and 0 “very unsatisfactory” (0%). Of the total 22 patients, 17 patients (77.3%) were willing to have further treatment, and 5 patients (22.7%) were not willing. Conclusion: Traditional Korean medicine treatment including acupotomy was an effective treatment for cervical herniated intervertebral discs. To determine the effect of an individual application (e.g., acupotomy) of traditional Korean medicine treatment for cervical herniated intervertebral disc, a prospective, controlled study is needed.

Follow-Up Magnetic Resonance Imaging Study of Non-surgical Spinal Decompression Therapy for Acute Herniated Intervertebral Disc: A Prospective, Randomized, Controlled Study

BackgroundNon-surgical spinal decompression therapy has been used for treating the lumbosacral herniated intervertebral disc as one of the conservative treatments. This study aimed to evaluate the effectiveness of the therapy in acute lumbosacral herniated intervertebral disc through magnetic resonance imaging.MethodsProspective, randomized, controlled study. Sixty patients with acute lumbar herniated intervertebral disc were randomized into either the decompression group (n = 30) or non-decompression group (n = 30). In the decompression group, non-surgical spinal decompression therapy was performed ten times in eight weeks. In the non-decompression group, pseudo-decompression therapy (no force) was performed with the same protocol. The change in the lumbosacral disc herniation index was evaluated through follow-up magnetic resonance imaging at three months after the therapy.ResultsThe change in herniation index after the therapy was −27.6 ± 27.5 (%) in the decompression group and −7.1 ± 24.9 (%) in the non-decompression group, with significant difference (P = 0.017). Approximately 26.9% of patients in decompression group and no patients in the non-decompression group showed over 50% reduction in herniation index (P = 0.031).ConclusionNon-surgical spinal decompression therapy can be a good treatment option for conservative treatment of acute lumbosacral herniated intervertebral disc.Trial registrationKorean Clinical Research Information Service (https://cris.nih.go.kr/cris/search/search_result_st01_en.jsp?seq=5355&ltype=&rtype=), Registration No. KCT0002614. Registered 26 December, 2017.