ACUTE EVENTS THAT LEAD TO LUMBAR DISC PROLAPSE- A STUDY IN A TERTIARY CARE CENTRE IN EASTERN INDIA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2019, Vol 8, Issue 1
Abstract
BACKGROUND Lumbosacral Radiculopathy is one of the most common disorders treated by neurologists and spine surgeons. Intervertebral disc herniation is the most common cause of lumbosacral radiculopathy in patients under the age of fifty years. There are some known factors which can increase the degeneration of lumbar disc like smoking, sedentary lifestyle, driving, male sex, increasing age, obesity, heredity and poor posture. Acute events can easily produce disc prolapse in an individual already having degenerated disc. A retrospective and prospective study was undertaken among patients of lumbar disc prolapse to measure the acute events that lead to disc prolapse. MATERIALS AND METHODS This study includes patients attending the outdoor department or those admitted in the Neurology Department of Calcutta National Medical College and Hospital with symptoms of lumbosacral radiculopathy. The study period was from 01/05/2016 to 30/04/2018. Inclusion criteria were radicular pain with or without sensory or motor signs with MRI evidence of root compression, patients with electrophysiology suggestive of radiculopathy in the absence of MRI evidence of compression and symptom onset within last three months. Exclusion criteria were patients below the age of 21 years and those above 60 years. Recurrent attacks, failed back surgery, cauda equina syndrome and red flags. Thorough history was taken from the patients and their family members particularly searching for acute events that lead to acute disc herniation. Examination was done to detect root affection by looking for muscular atrophy, loss of power and reflexes, dermatomal sensory loss and impaired straight leg raising test. Associated findings like loss of lumbar lordosis, reduced motion of spine, tilted spine and local vertebral tenderness were also looked for. In majority of the cases investigations were done after 6 weeks of conservative management to confirm or refute disc prolapse. Investigations were done like plain radiography, MRI of the lumbosacral spine in all cases, while nerve conduction study and electromyography were done in some cases where no MRI evidence of compression could be found. Study Design and Sample Size - This is a retrospective descriptive study and the Sample Size was 184 Patients. RESULTS In this retrospective descriptive study acute events noted within 48 hrs that led to lumbar disc prolapse are lifting of heavy weights 14.6%, bending 13%, falling 6.5 %, coughing 6.5%, sneezing 6.5%, twisting spine 5.9%, straining at toilet 3.8%, car accidents 3.8% and idiopathic 39.4%. CONCLUSION There is a need to increase awareness among both medical and the general population about the acute events that may lead to lumbar disc prolapse so that necessary precautions and life style modifications may be done.
Authors and Affiliations
Ramesh Bhattacharyya, Shantanu Ghosh, Kartick Chandra Ghosh, Sarbajit Das, Suman Das, Gouranga Prosad Mondal
Keywords
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- EP ID EP553021
- DOI 10.14260/jemds/2019/8
- Views 92
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