Lumbar Disc Erniation L4-L5; L5-S1: An Original Study - Abstract
Objectives or purpose or study design: To evaluate the Functional & Neurological outcome of Lumbar Microdiscectomy at L4/5 and L5/S1. Background: Lumbar disc herniation (LDH) is the most common specific cause for low back pain (LBP). It is a degenerative process causing annular tear with extrusion of the nucleus pulposus through posterior midline or posterolateral aspect of the disc leading to compression of the thecal sac and nerve roots with radicular symptoms. Surgery is reserved for only those who are refractory for a fair trial of nonsurgical management for at least 6 weeks, need of decompression for conus and cauda equina compression, needing immediate attention. There have been various modalities of treatment that have evolved over the years. Micro-lumbar discectomy is one of the latest additions of surgical management modality. Materials & Method: Retrospectively we reviewed 30 cases from january 2010 to december 2012 in hospital in ALTAMURA ITALY. All the patients had back pain & some neurological deficit with positive MRI findings, underwent lumbar microdiscectomy al L4/5 & L5/S1. Functional improvement was assessed by the ODI Score & categorized into excellent, good, fair & poor, Neurological improvement was assessed by the Nurick Score improvement of pain control by VAS score & overall functional assessment by modified Odom’s score. Results: Total number of patients was 30. Average age was 36 years (range 22-50). Average follow-up period was 9 months. Pre-operative ODI score was 54.6±12.8 & Post-operative score was improved to 10.2±3.3. In our series we have no chair bound or bedridden patients after surgery. The Pre-operative & Postoperative nurick score was 2.9 & 0.8 respectively. There was no difference in neurological outcomes comparing patients older and younger than 40 years. There was significant improvement in Pre-operative & Post- operative VAS score for leg pain was 6.90 ± 1.9 & 2.0 ± 0.8 respectively & for low back pain was 5.8±1.2 & 2.2±0.8 respectively. Conclusion: Lumbar Microdiscectomy is a safe & effective method to treat the patients with lumbar disc prolapse with shorter hospital stay & better prognosis with minimum & considerable complications.