Abstract

Aim: To correlate clinical and radiological outcomes of microscopic discectomy in patients with lumbar disc herniation.
Methodology: This was a prospective study conducted in the department of orthopedics period of 24 months on 60 patients scheduled for microlumbar discectomy for lumbar disc herniation. All patients first underwent conservative for the minimum period of three weeks, after which they were counseled for operative option. Those patients were included who had an unremitting sciatica, with or without back pain, and/or a neurological deficit that correlated with appropriate level and side of neural compression revealed on CT or MR imaging. We did not exclude patients who presented with other spinal degenerative conditions such as stenosis or arthritis with herniated disc because their symptoms were suggestive of the herniated disc. Patients with associated bony canal stenosis and spondylolisthesis were excluded. As with all surgical procedures, informed consent, demographic details, and clinical history were obtained and an explanation of risks, alternatives, and benefits was given.
Results: Out of 60 patients, majority of the patients were males (66.7%) and 33.3% were females. Average age of the patients was 43.75 years (21-68 years). All surgeries were single level microdiscectomy including L3-L4 (10%), L4-L5 (60%), and L5-S1 (30%). All the cases of L4-L5 and L3-L4 discectomy required fenestration of L4 and L3 lamina respectively while only 2 cases of L5-S1 required fenestration of the L5 lamina for the proper exposure of the disc space. Operative time on the average was 79 minutes (range 50 to 150 minutes). 80% of the patients had a stay of less than 5 days in the hospital, while 20% of patients had a stay of more than 5 days in the hospital. Disc sequestration (30%) and disc exclusion (26.7%) were the most commonly seen types of prolapse followed by central disc bulge (20%), disc protrusion (13.3%), and lateral disc bulge (10%). On assessing the outcome in patients in terms of returning to activities of daily living and satisfaction with surgery, 86.7% and 76.7% had score less than 2 respectively, while only 13.3% and 23.3% patients had a score more than two respectively.