Radiological evaluation of lumbosacral spine for post discectomy segmental instability

Area of Science:

• Orthopedic Surgery
• Spinal Biomechanics
• Radiology

Background:

• Lumbar disc herniation is a common condition requiring surgical intervention.
• Standard discectomy is a frequently performed procedure for lumbar disc herniation.
• Assessing postoperative spinal stability is crucial for patient outcomes.

Purpose of the Study:

• To evaluate the presence of segmental instability after standard lumbar discectomy.
• To compare translation and rotation measurements on functional radiographs with reference values.
• To investigate differences in instability between one-level and two-level discectomy procedures.

Main Methods:

• A study involving 71 patients who underwent standard lumbar discectomy for herniated discs.
• Patients were divided into one-level (Group A) and two-level (Group B) surgery groups.
• Postoperative functional lateral radiographs in a standing position were analyzed using computerized measurement of translation and rotation.

Main Results:

• Standard discectomy showed a statistically significant increase in translation at L4/L5 and a significant decrease in rotation across all measured levels compared to reference values.
• No significant differences in translation or rotation were found between one-level and two-level surgery groups for corresponding levels.
• Comparison between operated and adjacent levels, and measured versus predicted translation at L5/S1, did not reveal statistically significant differences.

Conclusions:

• Standard lumbar discectomy does not result in radiologically significant segmental instability.
• Performing two-level discectomy does not lead to more pronounced signs of instability compared to one-level surgery.