Functional outcome of conventional open discectomy versus minimally invasive surgery for lumbar disc prolapse: A non-randomised controlled study
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 2, Pages 1887-1893
AbstractLumbar prolapse of intervertebral disc (PIVD) is seen in over 1% of adults with the most incidence between the 3rd to 5th decades of life. It appears to be more prevalent in the male population and predominantly affects the L4-L5 and L5-S1 levels. Over the years several surgical techniques have been developed for its management but the best technique is still debatable.
Aims: This study aims to compare both immediate and long-term functional outcome following minimally invasive spine surgery (MISS) and open discectomies for Lumbar prolapse.
Settings and Design: It is a non-randomised controlled study.
Methods and Material: The patients, diagnosed with lumbar disc prolapse, were taken for the surgery of choice following an initial assessment. The outcome is assessed in the immediate post-operative period using VAS and ODI and long-term functional outcome using Modified macnab criteria between 12 and 18 months post-surgery.
Statistical analysis used: The IBM SPSS software was used to study the correlation. One-tailed ANOVA with CI of 95% was conducted for VAS score and ODI score while Mann-Whitney U test was done on the Modified Macnab Criteria.
Results: This study was conducted on 103 subjects with 56.3% undergoing open discectomies while 43.7% underwent minimally invasive discectomies. 73 subjects were operated on the L4-L5 level and 30 on the L5-S1 level. The study revealed that the operative duration of MISS is significantly more than that of open procedure. The VAS score for the MISS procedure had a mean change of 3.067 in the immediate postoperative period versus the mean reduction of 2.603 for open procedure. The ODI of MISS has decreased from 44.27 to 13.73 and that of Open procedure has decreased from 43.19 to 17.48. The long-term outcome at 12-18 months after surgery was excellent for 75.5% of MISS patients but only 25.9% open discectomy cases
Conclusions: The MISS procedure did not produce a strongly clinical outcome compared to open discectomies in the immediate after surgery but the functional outcome of MISS procedure on the long-term was greater than that of the conventional method
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