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Outcome analysis in 654 surgically treated lumbar disc herniations.
C T Pappas1, T Harrington, V K Sonntag
1Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona.
Neurosurgery
|June 1, 1992
Summary
This study on spinal surgeries found that most patients achieved good outcomes, with non-industrial injuries leading to better results than industrial ones. The Prolo scale effectively measured functional and economic recovery after procedures like microdiscectomy.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Surgery
Background:
- Spinal disc herniation is a common condition often requiring surgical intervention.
- Patient outcomes after spinal surgery vary, influenced by injury type and legal/industrial factors.
- Standardized outcome measures are crucial for comparing surgical techniques and patient cohorts.
Purpose of the Study:
- To evaluate the outcomes of 654 patients undergoing microdiscectomy or laminectomy procedures.
- To identify factors influencing surgical success, including injury cause and patient demographics.
- To assess the utility of the Prolo Functional-Economic Outcome Rating Scale in spinal surgery outcome assessment.
Main Methods:
- Retrospective analysis of 654 consecutive patients undergoing microdiscectomy, laminectomy plus microdiscectomy, or decompressive laminectomy with microdiscectomy.
- Data collection included patient demographics, injury mechanisms (lifting, falls, sports), symptom presentation (leg pain, radicular pain), and involvement in industrial accidents or legal claims.
- Patient outcomes were assessed using the Prolo Functional-Economic Outcome Rating Scale.
Main Results:
- The majority of patients (nearly 80%) achieved good outcomes (Prolo scores 8-10).
- Non-industrial injuries were associated with significantly better outcomes compared to industrial injuries.
- Patients with legal concerns and those with industrial insurance also demonstrated good outcomes.
- Complications occurred in nearly 11% of patients, with one mortality due to abdominal arterial bleeding.
Conclusions:
- Microdiscectomy and laminectomy procedures yield good outcomes for the majority of patients with spinal disc herniation.
- Injury mechanism and patient's industrial or legal status can impact surgical outcomes.
- The Prolo Functional-Economic Outcome Rating Scale is a valuable tool for objective comparison of surgical outcomes across different patient series and procedures.