الفهرس 
Aim of The WorkOnly 14 pages are availabe for public view
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Abstract
Low back pain is one of the most common reasons for people to seek medical
help; its prevalence ranges from 60–90%.
Lumbago is a general term referring for low back pain while Sciatica is a name
given to pain in the area of distribution of the sciatic nerve (L4 to S3) which is
commonly felt in the buttock and over the poster lateral aspects of the leg.
The most common cause of sciatica is lumbar disc herniation which may result
from acute traumatic injury or from preceding degenerative changes within the lumbar
disc. The degenerative disc disease (DDD) occurs even in asymptomatic patients, but
for about 10% of the population it results in permanent chronic pain and disability.
The lifetime prevalence of a lumbar disc herniation is approximately 2%. The
natural history of sciatica secondary to lumbar disc herniation is spontaneous
improvement in the majority of cases. Among patients with radiculopathy secondary
to lumbar herniation, approximately 10-25% (0.5 of the population) experience
persistent symptoms.
First-line treatments for sciatica are nonsurgical and may consist of physical
therapy, pharmacologic therapy, and/or epidural steroid injection. Acute sciatica
symptoms subside in most patients independent of treatment. For symptoms that are
resistant to initial conservative treatments, continued conservative care or lumbar
discectomy to remove the offending herniated disc material may be considered.
Lumbar microdiscectomy (MD) and open-discectomy (OD) are commonly
performed surgical procedures for patients with lumbar disc herniation. Mixter et al.
were the first to describe pitfalls of laminectomies and later in 1978 Caspar and
Williams initially reported the technique of lumbar MD, which slightly contributes to
a relatively smaller incision, less soft tissue damage, therefore reduced postoperative
pain, early discharge from hospital and return to work compared to OD.
The aim of this work was to compare the benefits and harms of minimally
invasive discectomy versus ordinary(conventional) discectomy for the management of
lumbar intervertebral discopathy. In our study, we focus on microscopic discectomy
from the different modalities of minimally invasive techniques.
This cross-sectional study was conducted at Menoufia University Hospitals &
Al-Haram Specialized Hospital including 72 Patients with single level disc prolapse
(L4-L5 or L5-S1). The patients were divided into two major groups (36 patients for
each group); the 1st one undergone conventional (ordinary) discectomy; the 2nd group
undergone minimally invasive discectomy (In our study we chosed microscopic
discectomy).
All patients included in this study were subjected to all of the following:
Full history taking: Personal history: Age, residence, work nature. Complains onset,
nature (pain, site, radiation, effect on daily work, pressure symptoms e.g.,
Incontinence). Medications used and frequency. Physical examination included
general condition, neurological examination and all patients were subjected to
assessment of the pain using VAS score. Investigations included routine pre-operative
Laboratory investigations: to evaluate patients’ fitness for the operative procedure
(CBC, ESR,CRP,INR, RBS, kidney functions, Liver functions, viral markers).
Radiological included dynamic X-ray to exclude instability, C-T lumbosacral spin and MRI lumbosacral spine .