European Journal of Molecular & Clinical Medicine

Abstract

Background & Objectives: This clinical study includes sixty cases of intervertebral disc prolapse in age group of 20 to 80 years, irrespective of sex, with clinical symptoms, signs and radiological evidence treated either conservatively or surgically with discectomy in the Department of Orthopedics at Nil Ratan  Sircar Medical College. All cases were followed up and functional results were analysed with primary objective to study the clinical presentations & evaluate outcomes of both conservative and surgical management and secondary objective to compare the results of both modes of treatment.
Methods: Out of 60 patients included in the study, 30 were treated conservatively & another 30 underwent standard discectomy in the Department of Orthopaedics at Nil Ratan Sircar Medical college, Study duration of Two Years. The short-term follow-up results in patients who were followed up for a minimum of 6 months after treatment were evaluated by using the Japanese Orthopaedic Association scoring system through direct examinations and questionnaires.
Results: Prevalence of disc prolapse was in age group of 20-50 years, while peak incidence between 30-40 years of age. Incidence of disc prolapse in males was almost twice as much as in females (in our series 65% male cases were noted). 56.67% cases had disc prolapse at L4-L5 level, which being the commonest site of disc prolapsed followed by L5-S1 41.67% and 1.67% at L3-L4 level.
Conclusion: With the execution of appropriate selection criteria and appropriate pre & post treatment planning, a good to excellent outcome was seen in nearly 97% in surgical study. In conservatively treated group, 90% patients showed fair to good result. Therefore lumbar discectomy is still a simple, safe & effective treatment with rapid relief for patient while conservative treatment if given to properly selected cases also gives effective results. Patients undergoing surgery for lumbar disc herniation achieved greater improvement than nonoperatively treated patients in all primary and secondary outcomes.