Functional Outcome of Discectomy for Lumbar Disc Prolapse

Abstract

Background: This study was to find out that whether the lumbar disc prolapse at different level influence the functional outcome of patients after discectomy. Present study is of 50 adult cases admitted at D. Y Patil Medical College. Common age group involved was between 40-60 years. Aims: To assess whether there is any difference in functional outcome of patients with disc prolapse at different levels in the lumbar spine after performing discectomy Objectives: To compare pre-operative and post-operative: • Leg pain and back pain by Visual Analog Scale Score • Functional outcome by Modified Oswestry Disability index score of the selected patients. Materials and methods: This study was a comparative study, conducted for a period of about two years, July 2014 to September 2016 in dr. D. Y. Patil Medical College, Hospital & Research Centre, only patients who were scrutinized for exclusion criteria and also abiding to inclusion criteria were included. Period required for data collection: 2 years. Period required for data analysis and reporting: - 6 months. We prospectively followed 50 consecutive patients with unilateral lumbar herniation either at L2-L3, L3-L4, L4-L5 or L5-S1 levels requiring surgery. The procedure performed was Micro lumbar discectomy in all patients. Results: A total of 50 patients were included in our study of which 4 (8%) patients had prolapsed intervertebral disc at L2-L3 level and 10 (20%) patients had disc prolapsed at L3-L4 level. These 14 patients were included in upper lumbar level disc herniation group referred hereafter as Group 1 (28%). 22 (44%) patients had disc prolapsed at L4-L5 level and 14 (28%) patients had disc prolapsed at L5-S1 level, these 36 patients were included in lower lumbar level disc herniation group who are referred hereafter as Group 2 (72%). On comparing the results after discectomy of prolapsed intervertebral disc at different levels in the lumbar spine we found no significant difference in the end result and functional outcome of the patients. Conclusion: The aim of this study was to find out that whether the lumbar disc prolapse at different levels influence the functional outcome of patients. According to the observations of this study and after reviewing various similar studies done in the past we conclude that after discectomy, level of disc prolapse per se has no significant bearing on functional outcome of the patients.