Lumbar Herniated Degenerated Disc: Simple Discectomy or Fusion?

Background Data: Low back pain is estimated to occur in 84% of individuals at some point of their life. Lumbar disc degeneration is one of the most common finding in the work up of low back pain. Mechanical, nutritional, and genetic factors may play a role in the pathogenesis of disc degeneration. T...

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Autor principal:	Alaa Abou-Shousha
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2013
Materias:	degenerative disc disease disc hernia simple discectomy lumbar fusion Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/ecd71954de944cc9a73ef6c774802443
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spelling	oai:doaj.org-article:ecd71954de944cc9a73ef6c7748024432021-12-02T04:21:50ZLumbar Herniated Degenerated Disc: Simple Discectomy or Fusion?DOI:10.21608/ESJ.2013.38072314-89502314-8969https://doaj.org/article/ecd71954de944cc9a73ef6c7748024432013-01-01T00:00:00Zhttp://esj.journals.ekb.eg/article_3807.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: Low back pain is estimated to occur in 84% of individuals at some point of their life. Lumbar disc degeneration is one of the most common finding in the work up of low back pain. Mechanical, nutritional, and genetic factors may play a role in the pathogenesis of disc degeneration. The etiology of back pain in degenerated disc is a complex process, and appears to be a combination of mechanical deformation and the release of inflammatory mediators. Being a recently highlighted illness, still there is a great controversy concerning the surgical treatment of degenerated lumbar disc hernia. Study Design: Prospective comparative clinical case study. Purpose: To compare the clinical outcome of patients presented with single degenerated lumbar disc hernia treated with fusion to those treated only with simple discectomy. Patients and Methods: Two groups of patients were recruited for this study included 20 patients each. Group A; patients treated with fusion and instrumental fixation. Group B; patients treated with simple discectomy. Both groups were homogeneous in terms of clinical presentation and imaging data. The VAS was used to evaluate leg and back pain, while ODI was used to evaluate the functional status both pre and post operatively. Results: Preoperatively, all patients suffered back pain, where 16 had moderate and 4 had severe pain in group A, and 14 had moderate and 6 had severe pain in group B. The ODI showed that, 16 and 17 patients had moderate disability in group A and B respectively. According to VAS, 12 patients had moderate and 8 had severe sciatica in group A, and 15 patients had moderate and 5 had severe sciatica in group B. With follow-up, back pain improved according to VAS, where 14 patients had no pain, 3 had mild and 3 had moderate pain in group A, and 18 (90%) patients had severe pain in group B. the ODI showed that 17 (85%) patients had minimal disability and 18 (90%) patients had moderate disability in group A and B respectively. According to VAS, 18 (90%) patients were pain free while 2 had mild sciatica in group A, and 17 patients became pain free in group B, however, 4 patients re-experienced moderate and 2 complained of severe pain due to recurrent disc. Conclusion: Despite the controversies regarding its ideal management, the results of discectomy and fusion stand better when compared with simple discectomy. However the disease needs more study to understand its pathogenesis. (2012ESJ034)Alaa Abou-ShoushaEgyptian Spine Associationarticledegenerative disc diseasedisc herniasimple discectomylumbar fusionNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 5, Iss 1, Pp 14-20 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	degenerative disc disease disc hernia simple discectomy lumbar fusion Neurology. Diseases of the nervous system RC346-429
spellingShingle	degenerative disc disease disc hernia simple discectomy lumbar fusion Neurology. Diseases of the nervous system RC346-429 Alaa Abou-Shousha Lumbar Herniated Degenerated Disc: Simple Discectomy or Fusion?
description	Background Data: Low back pain is estimated to occur in 84% of individuals at some point of their life. Lumbar disc degeneration is one of the most common finding in the work up of low back pain. Mechanical, nutritional, and genetic factors may play a role in the pathogenesis of disc degeneration. The etiology of back pain in degenerated disc is a complex process, and appears to be a combination of mechanical deformation and the release of inflammatory mediators. Being a recently highlighted illness, still there is a great controversy concerning the surgical treatment of degenerated lumbar disc hernia. Study Design: Prospective comparative clinical case study. Purpose: To compare the clinical outcome of patients presented with single degenerated lumbar disc hernia treated with fusion to those treated only with simple discectomy. Patients and Methods: Two groups of patients were recruited for this study included 20 patients each. Group A; patients treated with fusion and instrumental fixation. Group B; patients treated with simple discectomy. Both groups were homogeneous in terms of clinical presentation and imaging data. The VAS was used to evaluate leg and back pain, while ODI was used to evaluate the functional status both pre and post operatively. Results: Preoperatively, all patients suffered back pain, where 16 had moderate and 4 had severe pain in group A, and 14 had moderate and 6 had severe pain in group B. The ODI showed that, 16 and 17 patients had moderate disability in group A and B respectively. According to VAS, 12 patients had moderate and 8 had severe sciatica in group A, and 15 patients had moderate and 5 had severe sciatica in group B. With follow-up, back pain improved according to VAS, where 14 patients had no pain, 3 had mild and 3 had moderate pain in group A, and 18 (90%) patients had severe pain in group B. the ODI showed that 17 (85%) patients had minimal disability and 18 (90%) patients had moderate disability in group A and B respectively. According to VAS, 18 (90%) patients were pain free while 2 had mild sciatica in group A, and 17 patients became pain free in group B, however, 4 patients re-experienced moderate and 2 complained of severe pain due to recurrent disc. Conclusion: Despite the controversies regarding its ideal management, the results of discectomy and fusion stand better when compared with simple discectomy. However the disease needs more study to understand its pathogenesis. (2012ESJ034)
format	article
author	Alaa Abou-Shousha
author_facet	Alaa Abou-Shousha
author_sort	Alaa Abou-Shousha
title	Lumbar Herniated Degenerated Disc: Simple Discectomy or Fusion?
title_short	Lumbar Herniated Degenerated Disc: Simple Discectomy or Fusion?
title_full	Lumbar Herniated Degenerated Disc: Simple Discectomy or Fusion?
title_fullStr	Lumbar Herniated Degenerated Disc: Simple Discectomy or Fusion?
title_full_unstemmed	Lumbar Herniated Degenerated Disc: Simple Discectomy or Fusion?
title_sort	lumbar herniated degenerated disc: simple discectomy or fusion?
publisher	Egyptian Spine Association
publishDate	2013
url	https://doaj.org/article/ecd71954de944cc9a73ef6c774802443
work_keys_str_mv	AT alaaaboushousha lumbarherniateddegenerateddiscsimplediscectomyorfusion
_version_	1718401341705945088

Lumbar Herniated Degenerated Disc: Simple Discectomy or Fusion?

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