Outcome of Discectomy with Laminotomy for the Treatment of Prolapsed Lumbar Intervertebral Disc

Open Access

Abstract

Background: Prolonged lumbar intervertebral disc (PLID) is one of the leading causes of low back pain and sciatica. Discectomy with laminotomy is a popular surgical option in patients with PLID who do not respond to conservative management. This study aimed to determine the clinical outcomes of discectomy with laminotomy in patients with PLID. Methods & Materials: This prospective quasi-experiment was performed at the Department of Orthopedic Surgery, Dhaka Medical College Hospital, for a period of July 2018 to June 2020. 28 consecutive patients clinically and radiologically confirmed PLID, unresponsive to conservative treatment, were included through purposeful sampling. All included patients were subjected to discectomy, along with laminotomy, under general anesthesia. The endpoints were evaluated by the Visual Analogue Scale, Modified Macnab Outcome, and Straight Leg Raise Test. Follow-ups were carried out up to 16th months. Results: A total of 19 males (67.9%) and 9 females (32.1%) diagnosed with PLID were subjected to this study. The maximum age of the subjects ranged from 31-40 years (39.3%). The majority were manual workers (60.7%). L4/5 levels were predominantly involved (57.1%), and posterolateral disc prolapse was the main type (60.7%). Before the operation, the subjects had moderate pain (VAS scale=3.0±0.00) and limited SLR (42.63±6.30 degrees). Postoperative changes reflect a meaningful reduction of mean VAS scales to 0.24±0.64 at the third visit; similarly, there were improvements in SLR to 89.3±2.60 degrees. Following the Modified Macnab scale, there were excellent outcomes reported by 82.1%, good by 14.3%, and fair by 3.6%. Superficial wound complications were reported by one patient (3.6%). Mean hospital stay: 3. Conclusion: Discectomy with laminotomy is highly successful in PLID regarding pain relief, neurological recovery, and functional restoration, and is further characterized by a low rate of complications and hospital stay.