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ORIGINAL ARTICLE
Year : 2016  |  Volume : 3  |  Issue : 4  |  Page : 144-150

Prospective study of spectrum of lumbar disk herniation and its surgical outcome


1 Professor, Department of Neurosurgery, Vijayanagara Institute of Medical Sciences, Bellary, Karnataka, India
2 Associate Professor, Department of Community Medicine, Vijayanagara Institute of Medical Sciences, Bellary, Karnataka, India

Correspondence Address:
Vishwanath Sidram
Professor, Department of Neurosurgery, Vijayanagara Institute of Medical Sciences, Bellary, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.5005/jp-journals-10039-1107

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Objectives: To study the surgical outcome of lumber disk herniation and factors influencing the surgical outcome. Materials and methods: A case series study of 200 patients with herniated lumbar disk were studied in setting of tertiary hospital in the Department of Neurosurgery at Vijayanagara Institute of Medical Sciences, Bellary, Karnataka during the period of June 2013 to January 2015. Among the selected patients, the sociodemographic profile, clinical profile, radiological profile, and the surgical interventions were undertaken and the outcome was noted. The MacNab scale was used to determine the clinical outcome after surgery. All patients were followed for a period 6 months postoperatively for the presence of complications. Results: Mean age of the patients was 45.63 ± 18.54 years with 61% of males and 39% of them were females. L4-L5 interspace was involved in 138 cases (68.0%), disk was protruded in 54% of the cases, and extruded in 28% of the cases. According to MacNab's criteria, in this study “Excellent” outcome was seen in 146 patients (73%), outcome was “Good” in 45 (22.5%) patients, “Fair” in 7 (3.5%) patients, and “Poor” in 2 cases (1%). Better surgical outcomes were associated with younger patients (p = 0.002), disk prolapse at the level of L4-L5 (p < 0.001), extruded and protruded type of disk prolapse (p = 0.034), and disk prolapse precipitated by lifting inappropriate weight (p = 0.002). Conclusion: The outcome of lumbar discectomy depends more on patient's age, level and type of disk prolapse, factors precipitating disk prolapse, and patient selection than on surgical technique.


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