Influence of patient selection for successful lumbar discectomy
Keywords:
Lumbar disc herniation, Microdiscectomy, Laminectomy, TreatmentAbstract
OBJECTIVE: To ponder the influence of the proper application of the selection criteria on the surgical results of these patients.
METHODS: All patients in which lumbar discectomy was performed from September of 2005 until July of 2008 were studied. All were homogeneously selected according to the following surgical selection criteria: prevalence of radicular pain, detection of radicular signs, and non-improvement of the symptoms with conservative treatment during a minimum of two months, establishment of positive diagnosis of Lumbar Disc Herniation by means of CT scan or Magnetic Resonance, non-association with spinal stenosis or instability. According to neurosurgeon's preference, patients were operated by means of standard laminectomy or Caspar´s microdiscectomy. Using the statistical package SPSS 15.0, tests of Chi square and ANOVA were applied.
RESULTS: When comparing the affected vertebral level, predisposing and demographic factors, complications and postoperative evolution by means of Oswestry´s index at three and six months, they were not significant differences in relation to the surgical technique used.
CONCLUSIONS: The proper application of the surgical selection criteria to practice lumbar discectomy and the performance of a correct surgical technique, are the most important factors to achieve short term good results in these patients.
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References
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