Clinical analysis of fenestration technique for the treatment of lumbar disc prolapse

Abstract

Background: Major part of human population suffer from lumbago. It constitutes significant proportion of orthopaedic outpatient department clinic. Lumbar disc prolapse is important cause of back pain. This constitutes to sciatica in number of patients causing agonising disease due to radiculopathic leg pain. Wide range of treatment and techniques are present and have being devised to treat this disorder non-operatively and operatively. Operative techniques also vary a lot in the field of spine surgery depending on the centre, surgeon, diagnosis, symptoms, and cost factors. We present simple, cost effective operative technique with scientific basis in this paper. Methods: On the basis of inclusion and exclusion criteria 26 patients were operated by our fenestration technique. All the patients were followed up at the interval of 1 month, 3 months and 6 months. At the end of 1 month and 6 months, assessment was done of subjective and objective findings with Japanese Orthopaedic Association (JOA) score and Rate of improvement (RI) was calculated. Out of 26 patients 18 were men and 8 were women. Age ranges from 28 years to 72 years. Mean age being 47.8 years. Results: Out of 26 patients at the time of discharge, 20 patients (87.5%) could walk independently without any aid and without any radicular pain. In most of the patients 19(73.07%) sciatica improved immediately. The pre-operative mean +SD (SE) JOA score was 8.346 +0.85(0.169) which improved to 11.807 +0.694(0.136) after 1 month and 13.19 +0.895(0.175) after 6 months. Conclusion: Excellent to good results and improvement can be achieved surgically and economically by fenestration technique in the spine lumbar disc prolapse patients an many orthopaedic and spine centres easily with simple learning curve of the operating surgeon.