Title: A Prospective Clinical Study of Surgical Management of Lumbar Intervertebral Disc Prolapse in Adults by Laminectomy and Discectomy

Authors: Shaheed Abdul Arshad, Dr Viswanath Naik, Dr S Lakshmi Narayana

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i12.145

Abstract

Back pain, is now appearing as a modern international epidemic. Upto 80% of people are affected by this symptom at some time in their lives. Intervertebral disc disease and disc herniation are most prominent in otherwise healthy people in the 3rd and 4th decades of life. It accounts for a majority of cases of low backache seen by an orthopaedician in clinical practice and is a major contributor of functional disability.In 1934, Mixter and Barr published their study that concluded that laminectomy with decompression and extraction of herniated lumbar disc could, improve suffering caused by sciatic pain. Open discectomy is one of the standard procedure for operative intervention in patients with herniated limber discs whose conservative treatment has failed. However, the outcome studies of lumbar disc surgery document a success rate of 51 to 89%, in spite of advances in investigations, operative technique and postoperative care. Therefore the need for appropriately presenting and reviewing this subject is important.

Aims and Objectives

  • To study the outcome of the surgical management of lumbar intervertebral disc prolapse in adults by laminectomy and discectomy
  • To know the complications following laminectomy and discectomy for lumbar intervertebral disc prolapse

Methods: 30 Cases of lumbar disc prolapse treated with laminectomy and discectomy satisfying inclusion and exclusion criteria treated in MGM Hospital fromjuly 2015 to oct 2017 were studied.

Results: The present study comprised of 30 Cases of lumbar disc prolapse treated with laminectomy and discectomy. The follow up of upto 2 years. Male patients (60%) outnumbered female patients (40%) in incidence. More common in 40 to 60 years age group with the average of 44.9 years (18 to 64 years). Radicular pain was the most common symptom. Positive SLRT was the most common sign.76.67% of cases had a pre-op JOA score between 6 and 10.L4 -L5 was the most common disc to herniated. Average duration of hospital stay was 10.3 days ranging from 6 days to 24 days.93.3 % of cases had a post-op JOA score between 11 and 15.86.6% cases had a good outcome. Complications were superficial infection in 2 cases (6.6%), dural rupture in 2 cases(3.3%).

In our study we achieved 86% excellent to good results, 10% of fair results with a complication rate of 3.3% only. The results were comparable to other studies.

Keywords: laminectomy, Discectomy, Lumbar Disc prolapsed.

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