ANALYSIS OF 1058 LUMBAR PROLAPSED INTERVERTEBRAL DISC CASES IN TWO TERTIARY CARE HOSPITALS OF PAKISTAN
AbstractBackground: Characteristics of Prolapsed Intervertebral Disc (PID) in two tertiary care hospitals of Pakistan. The objective of this was to study the demographic characteristics of lumbar PID by age, gender, clinical presentation, levels of spinal column involvement, treatment options and post-operative complications for lumber disc prolapse. Methods: One thousand and fifty eight cases (708 males, 350 females) of prolapsed intervertebral disc over six years between January 2009 and December 2014 were studied for location of prolapsed disks, gender, age, clinical presentation, treatment options and complications of surgery. Results: Of the determined locations L5/S1 was the commonest (34.6%), followed by L4/L5 (33.4%). 24.2%of the patients had prolapsed disks at 2 levels (L3/L4, L4/L5 andL4/L5, L5/S1). Prolapsed disc was commonest in the 31–49 year age group. Male were mostly affected with male to female ratio of 2.02%. Most common surgery performed was discectomy with fenestration (60.64% of total surgeries performed) and most common postoperative complication being mechanical backache (4.8%). Conclusion: Prolapsed intervertebral disc is common in the lower lumbar region at the level of L4/L5 and L5/S1. The outcome of the patients who underwent surgery is very good with 92.19% of patients, being free of postoperative complications.Keywords: Backache, lumbar disc prolapse, discectomy, sciatica
Del Grande F, Maus TP, Carrino JA. Imaging the intervertebral disk: age-related changes, herniations, and radicular pain. Radiol Clin North Am 2012;50(4):629–49.
Gerald L. Burke. "Backache: From Occiput to Coccyx". MacDonald Publishing. Retrieved 2013;2–14.
Moore KL, Agur AMR. Essential clinical anatomy. 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2007. p.692.
Herkowitz HN, Rothman RH, Simeone FA, editors. Rothman-Simeone, the spine. 5th ed. Philadelphia: Saunders Elsevier; 2006. p.2.
Hsu WK. Lumbar and Cervical Disk Herniations in NFL Players: Return to Action. Orthopedics 2010;33(8):566–8.
Earhart JS, Roberts D, Roc G, Gryzlo S, Hsu W. Effects of lumbar disk herniation on the careers of professional baseball players. Orthopedics 2012;35(1):43–9.
Stafford MA, Peng P, Hill DA. Sciatica: A review of history, epidemiology, pathogenesis, and the role of epidural steroid injection in management. Br J Anaesth 2007;99(4):461–73.
Prasad R, Hoda M, Dhakal M, Singh K, Srivastava A, Sharma V. Epidemiological characteristics of lumbar disc prolapse in a tertiary care hospital. Internet J Neurosurg 2006;3(1).
Moein H. A retrospective study of 1250 cases of lumbar disc herniation operated upon at two hospitals of Isfahan University of Medical Sciences. J Kerman Univ Med Sci 3(1):1–6.
Ongeti KW, Ogeng’o J, Gakuu LN, Saidi H, Pulei A. Prolapsed Intervertebral Disc in an African Population: Kenyan Experience. East Afr Orthop J 2012;6(1):12–5.
Zeng YF. Clinical observation on treatment of 67 cases with lumbar intervertebral disc herniation with abdomen acupuncture. J Acupunct Tuina Sci 2008;6:42–5.
Toyone T, Tanaka T, Kato D, Kaneyama R. Low-back pain following surgery for lumbar disc herniation. J Bone Joint Surg Am 2004;86-A(5):893–6.
Siddiq M, Ali N, Jan WA, Dil R. Surgical Management of Lumbar Disc herniation by Standard Laminectomy in a Periphery Hospital; An experience with 64 patients. J Postgrad Med Inst Peshawar-Pak 2011;17(1).
Spengler DM. Lumbar Discectomy: Results With Limited Disc Excision and Selective Foraminotomy. Spine 1982;7(6):604–7.
ManoharaBabu KV. Surgical management of lumbar disc prolapse by fenestration technique. J Orthop 2006;3(4):e6.
Kendall D. The aetiology, diagnosis, and treatment of prolapsed intervertebral disk, with a review of 300 cases of sciatica. Q J Med 1947;16(3):157–79.
Yorimitsu E, Chiba K, Toyama Y, Hirabayashi K. Long-term outcomes of standard discectomy for lumbar disc herniation: a follow-up study of more than 10 years.Spine (Phila Pa 1976) 2001;26(6):652–7.
Bakhsh A. Long-term outcome of lumbar disc surgery: an experience from Pakistan. J Neurosurg Spine 2010;12(6):666–70.