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Lumbar disc prolapse: management and outcome analysis of 96 surgically treated patients
Objective:
To evaluate the presentation, diagnosis and management outcome of surgically treated patients of lumbar disc prolapse.
Design:
This is a prospective study. SETTING AND DURATION OF STUDY: The study was conducted at Department of Neurosurgery, Chandka Medical College Hospital, Larkana over a period of three years.
Subject And Methods:
Patients were selected using following neuroimagings like plain radiographs, myelograms, CT myelograms and MRI Scan of lumbosacral spine. The operative procedure applied was hemilaminectomy and removal of herniated disc material. Postoperatively patients were analyzed for outcome by standard subjective analysis (Mac nab criteria), objective examinations and radiographic studies.
Results:
There were 96 patients, 70 males and 26 females. Predominant mode of presentation was low back pain with radiation to leg (46.9%), neurogenic claudication in 18 patients (18.7%). Eighty Six percent of the disc prolapses were found at L4 L5 and L5 SI levels. Complication rate was 14.6% with infections being commonest. Excellent to good outcome was found in 85.4% of the cases. Mean follow up period was 18 months.
Conclusion:
Surgery for cauda equina syndrome and motor deficits has a good outcome with hemilaminectomy and is the best surgical option for large disc prolapses.
