Available online at www.medicinescience.org
ORIGINAL RESEARCH
Medicine Science 2018;7(4):745-7
Evaluation of pain status and quality of life in patients with lumbar disc hernia who
underwent microdiscectomy
Abdurrahman Cetin
1
, Mehmet Tahir Gokdemir
2
1
Health Sciences University, Gazi Yasargil research and training Hospital, Brain and Neurosurgery, Diyarbakir, Turkey
2
Health Sciences University, Gazi Yasargil research and training Hospital, Emergency Department, Diyarbakir, Turkey
Received 26 March 2018; 09 April 2018
Available online 21.07.2018 with doi: 10.5455/medscience.2018.07.8845
Copyright © 2018 by authors and Medicine Science Publishing Inc.
Abstract
The objective of this study was to evaluate the emotional state, pain status, and quality of life in patients with lumbar disc herniation using preoperative Oswestry Disability
Index (ODI), Visual Analog Scale (VAS), and 1- and 3-months postoperative VAS scores. Between December 2017 and March 2018, 49 patients with lumbar disc herniation,
who were admitted to our neurosurgery department, were enrolled in this retrospective study. According to the ODI questionnaire, pre- and postmicrodiscectomy analysis
revealed a statistically signifcant improvement in all the parameters (for all parameters, p < 0.001). VAS scores of the patients showed a signifcant gradual decrease
in the severity of pain at 1 and 3 months following the operation (p < 0.001). It was observed that lower back pain and quality of life in patients improved following
microdiscectomy surgery. Microdiscectomy surgery is still an important option in lumbar disc herniation treatment.
Keywords: Lumbar disc herniation, visual analog scale (VAS), microdiscectomy
Medicine Science
International
Medical Journal
745
Introduction
Lumbar disc herniation is one of the primary causes of chronic
lower back pain. It is a pathological process rather than a medical
condition and occurs mostly at the lower lumbar spine, particularly
at the L4-L5 and L5-S1 levels. Lower lumbar vertebrae, which
carry a large amount of body weight, frequently degenerate,
eventually leading to a breakdown of fbrous cartilage material
(annulus fbrosus) and herniated nucleus pulposus. The most
common symptom of patients with disc herniation is blunt
and severe pain that spreads to the lower extremities from time
to time. Symptoms occur depending on the anatomic location
where a physiopathologically herniated nucleus pulposus creates
compression. Median-level compression causes lower back pain,
and lateral-level compression causes leg pain [1,2].
There are several surgical approaches for lumbar disc herniation,
such as median-level, lateral, paraspinal, and intertransverse.
Surgical procedures used for these approaches include open
surgery, microsurgery with surgical microscopes, endoscopic
surgery via a thin tubular channel, and percutaneous surgery [3].
In addition, the choice of surgical procedure mainly depends on
the infrastructure of the hospital and the experience and preference
of the surgeon.
*Coresponding Author: Mehmet Tahir Gokdemir, Health Sciences University,
Gazi Yasargil research and training Hospital, Emergency Department, Diyarbakır,
Turkey, E-mail: drtahirgokdemir@gmail.com
The objective of this study was to evaluate the emotional state,
pain status, and quality of life in patients with lumbar disc
herniation using preoperative Oswestry Disability Index (ODI),
Visual Analog Scale (VAS), and 1- and 3-months postoperative
VAS scores.
Material and Methods
The study designed as a questionnaire study. Sixty-fve patients
underwent microdiscectomy with a diagnosis of lumbar disc
herniation were admitted to the neurosurgery department of our
Hospital, between December 2017 and March 2018. Sixteen
of these 65 patients were excluded due to lack of data, and 49
patients were included in the study. Lumbar magnetic resonance
imaging (MRI) was frst performed to confrm the diagnosis of
lumbar disc herniation in these patients who were referred to the
neurosurgery department due to lumbar pain. Electromyography
(EMG) and spinal MRI myelography were performed if required.
The surgical intervention decision was made on the basis of the
clinical examination, MRI, spinal MRI myelography, and EMG
results. Lumbar microdiscectomy was performed with patients
under spinal anesthesia or general anesthesia. Following dermis
and subcutaneous tissue, fascia was incised. The muscles were
incised by blunt dissection. A Taylor retractor was placed at the
disc level. Soft tissues were cleaned with a rongeur. After placing
a microscope into the surgical area, hemi-partial laminectomy
was performed. Following hemostasis, ligamentum favum was