الفهرس | Only 14 pages are availabe for public view |
Abstract SUMMARY • Lumbar disc herniation remains to be a major health problem being a source of economic loss for individual &society. • Herniation of nucleus pulposus causes radiculopathy that is produced by combination of mechanical, inflammatory&chemical changes. • Sciatica is often the symptom lumbar disc disease and patient may complains of parasthesia, numbness, bladder disturbances & weakness. • Signs of L.D.P. include sensory, motor deficit &reflex affection. • The most diagnostic investigation is L.S.S.M.R.I. • Conservative treatment is initially followed by surgical treatment in patients with unimproved sciatica, pain, cauda-equine syndrome. • The conventional classic open lumbar discectomy is considered the corner stone of lumbar disc surgery, however there are many alternative minimal invasive techniques including microdiscectomy, automated percutaneous discectomy ,chemonuclosis , endoscopic discectomy , laser discectomy. • Lumbar microdiscectomy allows spinal surgeon to decompress a symptomatic lumbar nerve root by using a minimal invasive surgical approaches .it reduces tissue trauma, allows direct visualization of nerve root and disc and enables bonny decompression. • It has many advantages such as less tissue damage, small wound, minimal blood loss , short hospital stay , early recovery and return to work. • As any spinal surgery it carries complications as nerve root injury, dural tear, csf leak and infection . Results: Hospital stay and surgery time were short. Significance improvement occurred in VAS and ODI; VAS improved from 7.67±1.06 to 1.47±0.78 (P<0.001), and ODI improved from 73.37±7.8 to 10.10±3.8 (P<0.001). also patient generally returned early to their usual activities. Complications were minimal include one case of csf leak (3.3%),one case of dural tear (3.3%) , two cases of infection (6.7%) and 2 cases had intra-operative bleeding <300 cc and had drains (6.7%). Conclusion: Microscopic lumbar discectomy in middle aged population is a safe and effective for patients with symptomatic lumbar disc prolapsed who failed proper non-surgical treatment. It offered short surgical time, short hospital stay, less complication, and excellent results, with early return to usual activities. |