A Study to Assess the Functional Outcome After Laminotomy and Microdiscectomy in Lower Lumbar Disc Prolapse

Volume 6 | Issue 2 | May-Aug 2018 | Page 12-15 | Deepak Hegde, Arjun Ballal, Hishanil Rasheed

Authors: Deepak Hegde [1], Arjun Ballal [2], Hishanil Rasheed [1].

[1] Department of Orthopaedics, K.S Hegde Medical Academy, Mangalore – 575 018, Karnataka, India,

[2] Department of Orthopaedics, Consultant Orthopaedic Surgeon, Ballal Healthcare, Udupi – 576 105, Karnataka, India.

Address of Correspondence
Dr. Deepak Hegde,

Department of Orthopaedics, K.S Hegde Charitable Hospital,

Medical sciences Complex, Deralkatte, Mangalore – 575 018, Karnataka, India.

E-mail: arjchess_lp@rediffmail.com

Abstract

Background: Advances in technology with better surgical techniques and instrumentation have proved time and again to reduce the incidence of complications and cosmetic morbidities caused by the traditional techniques in the management of intervertebral disc prolapse of the lumbar spine. By limiting the width of the surgical corridor the risk of muscle crush, exposure of soft tissues for infection and post-operative morbidity and complications can be minimized by great amounts.

Aims and Objectives: The aim of the study was to assess the functional outcome of the spine after laminotomy and microdiscectomy in cases of lower lumbar intervertebral disc prolapse.

Materials and Methods: A prospective study was conducted in the department of orthopedics of a teaching hospital in Southern India. A total of 28 diagnosed cases of intervertebral disc prolapse at L5-S1 levels were included in the study. The preoperative functional status was assessed as per the modified oswestry disability index (ODI) and visual analog scale (VAS). All of them underwent laminotomy of L5 vertebra and microdiscectomy at L5-S1 level. The patients were reviewed at postoperative weeks 6, 12, and 24 and the functional status of the spine was assessed and tabulated using the modified ODI and VAS. All results were tabulated and calculated with repeated measures ANOVA using SPSS software version 20.0.

Results: It was noted that the modified ODI scores preoperatively had a mean of 75 ± 11.85% which improved to 55 ± 9.18% at 6 weeks, 45 ± 9.37% at 12 weeks, and 36 ± 8.65% at 24 weeks. The VAS scores were noted to have a mean of 8 ± 0.93 mm preoperatively. It was noted to have improved to 6 ± 0.93 mm at 6 weeks, 5 ± 0.74 mm at 12 weeks, and then to 5 ± 0.73 mm at 24 weeks. This showed that there was an improvement in the back function after surgery in all the cases. No complications were noted in any of the cases.

Conclusion: Laminotomy and microdiscectomy level is an excellent technique of management of intervertebral disc prolapsed of L5-S1 with minimal complication rate.

Keywords:  Visual analogue scale, Oswestry Disability Index, lumbar spine, laminotomy, microdiscectomy.

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