Clinical Outcome of Fenestration as Minimally Invasive Surgery for Lumbar Disc Herniation: Successes and Obstacles
Keywords:
Microdiscectomy, Lumber disc, Herniation., fenestration, visual analogue scaleAbstract
Objective: To assess the clinical outcome of fenestration as minimally invasive surgery among patients with lumbar disc herniation undergoing microdiscectomy.
Methods: This retrospective observational study was conducted at the Neurosurgery Department of Jinnah
Postgraduate Medical Centre (JPMC), Karachi from June 2015 to December 2019. Patients with single-level unilateral side lumbar disc herniation underwent microdiscectomy, age more than 18 years of either gender were consecutively included. The patients were observed for pre and post-surgical pain improvement using a rd visual analogue scale (VAS). The follow-up was conducted at 3 months of treatment.
Results: A total of 247 cases were enrolled. The mean age was 47.57 ±8.22 years. There were 152 (61.5%) males and 95 (38.5%) females. Back pain and radiating leg pain, i.e. 182 (73.7%) and 139 (56.3%) respectively were the most common complaints. Complications were reported in 19 (7.69%) cases. Of these 19 cases, 8 (42.10%) had discitis, 6 (31.57%) had superficial infection, and 5 (26.31%) had dual tear. The VAS score was markedly improved when compared among pre and post-operative cases (7.56 ±1.01 vs. 2.46 ±0.84, p-value <0.001, 95% CI 4.94-5.25).
Conclusion: Our study shows that a microdiscectomy is an effective approach with removal for the unilateral disc with a small incision, early mobilization, low rate to morbidity and success rate based on VAS scoring system was 86.6% ranged from good to excellent.
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