Functional and Neurological Recovery Patterns Following Discectomy with Laminotomy for Prolapsed Lumbar Intervertebral Disc

Open Access

Abstract

Background: Prolapsed lumbar intervertebral disk (PLID) remains a prominent cause of impairment in working-age people, necessitating surgical surgery when conservative treatment fails. This study aimed to assess functional and neurological recovery patterns after discectomy with laminotomy for PLID. Methods & Materials: This study was conducted at the Department of Orthopedic Surgery, Dhaka Medical College Hospital, from July 2019 to June 2021, on 28 radiologically confirmed PLID patients. Patients with nerve root compression and predominant leg pain unresponsive to conservative management were included. Outcome was measured using VAS, Modified Macnab criteria, and straight leg raising. Results: Males comprised 67.9% of the patients, and 39.3% were between the ages of 31 and 40. 67% of the patients were manual laborers. The L5 dermatome was most commonly affected by preoperative sensory impairments (57.1%), whereas the extensor hallucis longus was most commonly affected by motor weakness (57.1%). The mean VAS ratings dropped by 92%, from 3.00±0.00 before surgery to 0.24±0.64 at the last follow-up (p<0.001). The improvement in straight leg raising was from 42.63±6.30 degrees to 89.30±2.60 degrees (p<0.001). Neurological recovery revealed that 85.7% of patients had complete motor recovery and 89.3% had complete sensory recovery. The Modified Macnab criteria showed that only one superficial problem (3.6%) was documented, whereas 96.4% of patients had excellent or good results. 3.82±2.39 days was the average length of hospital stay following surgery. Conclusion: Excellent functional and neurological recovery with minor issues is demonstrated by discectomy combined with laminotomy for PLID. Significant pain relief, the ability to raise one's leg straight again, and a high incidence of full neurological recovery are all provided by the treatment, especially for L5 and S1 nerve root involvement.