Clinical outcomes in patients undergoing microlumbar discectomy for lumbar disc herniation

Abstract

Introduction: Lumbar microdiscectomy has been associated with high rates of success and low postoperative morbidity. We aimed to evaluate the clinical outcome of patients undergoing lumbar microdisectomy for disc herniations. Methodology: The study was performed in the Department of Orthopedics, Lokmanya Hospital Chinchwad and Lokmanya Hospital Nigdi, Pune from August 2002 till May 2004 on all patients scheduled for microlumbar discectomy for lumbar disc herniation. Intra-operatively, type and level of prolapse and operative time was noted. We also noted the length of hospital stay and any complications experienced by the patient. For assessing the patients, instruments like Visual Analog Scale (VAS) for pain at the end of first week and return to normal activity of daily living (ADL) and satisfaction with the result of surgery at the end of six months were used. Results: All surgeries were single level microdiscectomy. Operative time on the average was 85 minutes and 83% of the patients had a stay of less than 5 days in the hospital. Disc sequestration and disc exclusion were the most commonly seen types of prolapse. Pre-operatively five patients had a back pain VAS of more than 4 and four patients had a leg pain VAS of more than 4. On assessing the outcome in patients in terms of returning to activities of daily living and satisfaction with surgery only four and five patients had a score more than two respectively. Conclusions: Proper preoperative planning and correct surgical technique can prevent complications in these cases. Future multicentric studies with larger sample size and longer follow up periods are needed to support our findings.