Prospective Study of Outcome of Minimally Invasive Open Discectomy in Single Level Lumber Disc Herniation

Abstract

AIMS: To study the functional outcome, incidence, degree of pain improvement, neurological improvement and complication following Minimal invasive open lumbar discectomy in single level lumbar disc herniation.

METHOD: This prospective study was carried out at Department of Orthopedics of UCMS-TH between November 2016 to July 2017 with symptomatic lumbar disc herniation with failed conservative treatment and who have fulfilled the inclusion criteria were enrolled into this study. Evaluations of the patients were done post-operatively at fourteen post operative day, one month and three months. At each assessment detail clinical and neurological examination was done with ODI and VAS assessment

Results: In our study sample size was 30 in which the mean age was 41.7 years ranging from 20 to 65 years. Among 30 patients, 18 were male and 12 were female. 17 patients (56.7%) were of self employed group, 8 patients (26.7%)were housewife,2 patients (6.7%) were farmer,2 patients (6.7%) were public servant and 1 patients (3.3%) was ex army . Average blood loss was 93.9 ml. minimum 70 ml to maximum 120 ml. The mean operative time duration was 90 minutes, minimum 58 to maximum 120 minutes. Pre operative mean ODI score was 46.06, one month mean ODI was 33.73 and on three month mean ODI was 22.93.Mean for VAS for leg pain pre operatively was 7.43, one month follow up score was 5.06 and lastly three month score was 3.43. One patient had dura tear as intra-operative and two patients had discitis as late complication.

Conclusion: Minimal invasive open discectomy is best treatment for symptomatic lumber disc herniation who had failed conservative treatment in our locality and developing country like Nepal.