Lumbar Disc Prolapse: Microdiscectomy and its Clinical Outcomes

Abstract

Background: Prolapse lumbar intervertebral disc (PLID) is a localized disc displacement outside its margins is the most common source of sciatica pain, involving 1%-5% of the population annually. Standard management includes conservative management initially for a period of around 6 weeks. In general, microdiscectomy (MD) is considered a standard procedure for symptomatic cases, with approximately 60%-80% of satisfactory results. In this study, we aimed in describing experience of MD in patients diagnosed with PLID.

Methods: This retrospective study has been conducted at Dr. Ziauddin University hospital, Karachi; Pakistan. The medical records from 2018 to 2020, of microdiscectomy for prolapsed intervertebral lumbar disc were studied. All patients of 18 years or more admitted with symptomatic PLID, and proceeded to single level MD have been included. The regular pre-operative work-up, surgical technique and post-operative management was followed. Data collection was performed using a standard proforma. Utilizing SPSS version 23.0, all statistical analyses were carried out a p <0.05 was considered statistically significant.

Results: Mean age of patients was 43 to 42 years and Male: Female ratio was 1.6:1 and pre-operative neurological deficit was observed in 28 (42.4%) patients. Most common affected disc spaces were L4-L5 35(53%) and L5-S1 26 (39.4%). Left side disc Prolapse was found more affected as 39(59.1%) cases reported among the total. Visual analog scale (VAS) score dropped from more than 5 to no pain after surgery.

Conclusion: Microdiscectomy is a safe treatment in prolapsed intervertebral lumbar disc for patients with failed conservative therapy and reported excellent outcomes with earlier surgical intervention.

Keywords: Discectomy; Intervertebral Disc Displacement; Radiculopathy.