A CLINICAL STUDY OF SURGICAL MANAGEMENT OF LUMBAR DISC PROLAPSE BY LAMINECTOMY AND DISCECTOMY
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2019, Vol 6, Issue 4
Abstract
BACKGROUND Back pain, the ancient curse is now appearing as a modern epidemic. Humans have been plagued by back and leg pain since the beginning of recorded history. Lumbar discs are responsible for well over 90% of all organic symptoms attributable to low backache. Clearly lumbar disc herniation is a significant medical and social problem. What is less clear is the efficacy of treatment and type of treatment to choose. In 1934, Mixter and Barr published their study and concluded that laminectomy with decompression and extraction of herniated lumbar disc could improve suffering caused by sciatic pain. Since then increasing number of patients have been operated upon for this disorder. Open discectomy is now the “gold standard” for operative intervention in patients with herniated lumber 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, appropriately presenting and reviewing this subject is important. MATERIALS AND METHODS The study was conducted among 30 patients with signs and symptoms of lumbar disc prolapse who got admitted from OPD and casualty of Government General Hospital, Kurnool between November 2015 to October 2017. Patients were operated for lumbar disc prolapse by Laminectomy and Discectomy and followed for 4 to 24 months. RESULTS Average duration of hospital stay was 10.3 days ranging from 6 days to 24 days. 96.6% of cases had a post-op JOA score between 11 and 15.80% cases had good outcome. Complications were superficial infection in 1(3.3%) case, discitis in 1(3.3%), dural tear in 1(3.3%). CONCLUSION In our study we achieved results comparable to that achieved with microdiscectomy. Microsurgical techniques may have some advantages in terms of a less invasive approach; shorter hospital stay etc., but one must understand the demands, requirements, and limitations of this technique. It also has a long learning curve and is technically a more demanding procedure in terms of surgical skills of the surgeon and equipment required and thus is available only in multispecialty hospitals. Also, standard laminectomy and discectomy is more cost effective than microdiscectomy. Therefore, for the Indian scenario, standard laminectomy and discectomy is still the “Gold Standard” in operative treatment of lumbar disc prolapse.
Authors and Affiliations
Rajesh Kumar Mallepogu, Aasupathri Pavana Kumar Babu, Thadi Raghavendera Rao, Sreekanth Reddy B.
Keywords
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- EP ID EP610097
- DOI 10.18410/jebmh/2019/45
- Views 68
- Downloads 0
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