Study of Clinical Variables Affecting Long Term Outcome after Microdisectomy for Lumbar Disc Herniation

Shrestha, D; Shrestha, Rajan; Dhoju, D; Kayastha, Suresh; Jha, Subash Chandra

doi:10.3126/kumj.v13i4.16833

Cited by 10 publications

(19 citation statements)

References 16 publications

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“…The current study showed better clinical and functional outcomes with early surgical intervention by microdiscectomy as reported by studies [8][9][10][11][13][14]16,18] while study of Shrestha et al [12] showed no signi cant correlation between duration of symptoms and ODI. Gelalis et al [17] showed no impact of duration of symptoms on clinical outcomes.…”

Section: Comparison With Other Studiessupporting

confidence: 73%

“…There are many factors can affect the clinical and functional outcomes after lumbar microdiscectomy as duration of symptoms before surgery. Although, there is no agreement among the previous studies about the certainty of the effect of preoperative duration of symptoms on patients' clinical and functional outcomes after microdiscectomy and absence of randomized controlled trial regarding this issue [8][9][10][11][12][13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 98%

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Effect of Duration of Symptoms on the Clinical and Functional Outcomes of Lumbar Microdiscectomy: A Randomized Controlled Trial

Hamawandi¹

2020

Preprint

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Background Microdiscectomy is the gold standard surgical procedure for symptomatic lumbar disc herniation. The aim of this study is to determine whether the preoperative duration of symptoms can affect the postoperative clinical and functional outcomes after microdiscectomy for symptomatic lumbar disc herniation. Method A single blind, randomized controlled trial was performed by single spine surgeon on patients with symptomatic lumbar disc herniation. 122 patients, who had eligibility criteria, were divided randomly by computer system into 3 groups (A, B and C) who were operated at six weeks, three months and six months from the onset of symptoms respectively. 97 patients were analyzed at the end of this study for outcome measures. Primary outcome measures are Oswestry disability index, Roland-Morris Questionnaire and Visual analogue scale for back pain and leg pain. Secondary outcome measures are post-operative complications, length of hospital stay and time of return to daily activities.Results Better results among study’s groups were in sequence of group A, group B then group C. There was significant difference in Oswestry disability index score until three years of follow up (P-value <0.001). Improvement in Roland-Morris Questionnaire among the groups was significant at three months post-operatively (P-value <0.001). Visual analogue scale for back pain was better significantly at 2 weeks post-operatively (P-value=0.002) while Visual analogue scale for leg pain was better significantly at 3 months postoperatively (P-value=0.003). There was no significant difference among study’s groups regarding other outcome measures.Conclusion Preoperative duration of symptoms in patients with lumbar disc herniation can affect the clinical and functional outcomes after microdiscectomy. The shorter duration of symptoms the better postoperative outcomes are. This effect of duration of symptoms on postoperative outcomes is more significant in early postoperative period.Trial registration NCT, NCT04538027. Registered 1 September 2020 -Retrospectively registered, https://www.clinicaltrials.gov/NCT04538027

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Section: Comparison With Other Studiessupporting

confidence: 73%

Section: Introductionmentioning

confidence: 98%

Effect of Duration of Symptoms on the Clinical and Functional Outcomes of Lumbar Microdiscectomy: A Randomized Controlled Trial

Hamawandi¹

2020

Preprint

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“…concluded that more or less than 12 months duration of preoperative sciatica may not affect the surgical outcomes of simple disc herniation after discectomy. Shrestha et al 12 . showed in their study that preoperative duration of symptoms did not affect the post‐operative patients' outcomes measured by Oswestry Disability Index (ODI).…”

Section: Introductionmentioning

confidence: 97%

Effect of Duration of Symptoms on the Clinical and Functional Outcomes of Lumbar Microdiscectomy: A Randomized Controlled Trial

Hamawandi

Sulaiman

Abdulhameed³

2021

Orthopaedic Surgery

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Objectives The objective is to determine whether the preoperative duration of symptoms can affect the clinical and functional outcomes after microdiscectomy. Method This study is a single blind randomized controlled trial with level 1 evidence. From 3 January 2016 to 15 February 2017, 122 adult patients with symptomatic lumbar disc herniation were divided randomly by computer system into three groups were treated by microdiscectomy at 6 weeks, 3 months and 6 months from onset of symptoms respectively. Ninety‐seven patients, age (19–47) years, 42 males and 55 females, were analyzed at the end of this study with 3 years of follow up. Primary outcome measures are Oswestry Disability Index (ODI), Roland‐Morris Questionnaire (RMQ) and Visual Analogue Scale (VAS) for back pain and leg pain. Secondary outcome measures are post‐operative complications, length of hospital stay and time of return to daily activities. Results There was significant difference in VAS for back pain among study groups (P = 0.002) at 2 weeks). There were significant differences in VAS for leg pain among study groups (P < 0.001) at 2 weeks and at 3 months (P = 0.003). There was significant difference in ODI among study groups at 2 weeks, 3, 6 months, 1, 2 and 3 years (P = 0.037 at 2 weeks and P < 0.001 at other periods of assessments) and we found that the mean of ODI in group 6 weeks was better than group 3 months and this was better than group 6 months in all periods of assessment. Group 6 weeks was better than group 3 months and this was better than group 6 months in postoperative improvements regarding RMQ with significant difference at 2 weeks postoperatively (P < 0.001) and at 3 months postoperatively (P < 0.001). Conclusion Duration of preoperative symptoms, in patients with lumbar disc herniation, can affect the clinical and functional outcomes after lumbar microdiscectomy as the shorter duration of symptoms resulted in better postoperative clinical and functional outcomes.

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“…3 Nepal Journal of Neuroscience, Volume 18, Number 1, 2021 There have been very few studies looking into the postoperative quality of life of these patients in Nepalese population. 4 There are various QOL related questionnaires available. Among them the Short Form-36(SF-36) is a standardized questionnaire for measuring QOL.…”

Section: Introductionmentioning

confidence: 99%

Quality of life after lumbar microsciopic discectomy

et al. 2021

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Introduction Lumbar disc herniation also known as prolapsed intervertebral disc is one of the well-known causes of low back pain. Among various modalities of treatment, surgery is often kept as the last resort when conservative treatment fails. Conventional surgical methods have been replaced by minimally invasive surgeries like microscopic, endoscopic and percutaneous lumbar discectomy in the hopes of decreasing post-operative pain. However, it is not uncommon for patient to have residual pain even after discectomy. Patients also complains of reduced quality of life (QOL). SF-36 is a standardized questionnaire for measuring QOL. Few studies have used this questionnaire to look into QOL of these patients but no such study is available in Nepalese perspective. Materials and Methods A prospective cross-sectional study was conducted among all patients undergoing single level unilateral microscopic lumbar discectomy in Upendra Devkota Memorial National Institute of Neurological Sciences from February 1st 2017 to January 31 2018. After taking informed consent, subjects were asked to respond to the preformed questionnaire and SF-36 survey. Interviews were individually conducted by the same investigator at two different time points: i) before lumbar discectomy. ii) 3 months after lumbar discectomy. QOL scores before and after were compared. Results Total of 50 patients meeting the inclusion criteria were studied. The mean age of the study group was 38.7 ± 9.9 years with male preponderance of 76%. The median duration of exacerbation of symptoms was 4 weeks. Along with pain, 64% had sensory deficit whereas 52% had motor deficit. Surgery led to significant improvement in pain score as well as marked improvement of SF 36 quality of life score at 3 months of surgery. However, age, gender, duration of symptoms or presence of sensory or motor deficit before surgery did not predict improvement in overall QOL. Conclusion Patients undergoing microscopic lumbar discectomy for prolapsed intervertebral disc have significant improvement in pain score and QOL after 3 months of surgery.

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Study of Clinical Variables Affecting Long Term Outcome after Microdisectomy for Lumbar Disc Herniation

Abstract: Background

Cited by 10 publications

References 16 publications

Effect of Duration of Symptoms on the Clinical and Functional Outcomes of Lumbar Microdiscectomy: A Randomized Controlled Trial

Effect of Duration of Symptoms on the Clinical and Functional Outcomes of Lumbar Microdiscectomy: A Randomized Controlled Trial

Effect of Duration of Symptoms on the Clinical and Functional Outcomes of Lumbar Microdiscectomy: A Randomized Controlled Trial

Quality of life after lumbar microsciopic discectomy

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