Evaluating Possible Predictive Factors for Open Lumbar Disc Surgery

Background: Lumbar open discectomy is a frequently used method for treating lumbar disc herniation that requires spinal surgery. Although patients can have the same sickness, the outcome can be different. Therefore, determining the prognostic factors that affect the surgical outcome would be helpful for decision making concerning surgery. Objectives: The aim of the current study is to examine the clinical and radiological factors affecting the postoperative outcome of patients with lumbar herniated disc and who underwent open lumbar discectomy. Patients and Methods: This analytical study was a prospective study conducted on 120 patients who were diagnosed with lumbar disc prolapse and admitted in Ain Shams University Hospitalsdepartment of Neurosurgery. Results: Final follow up Oswestry Low Back Pain Disability Questionnaire (ODI) was significantly lower (p=0.027) in patients with preoperative duration of LBP 8 months. Also, it was significantly lower (p = 0.04) in L5-S1 disc herniation and in lateral (p = 0.0086) disc herniation as compared with central disc herniation. As regard Pfirrmann’s degenerative grade, there was significantly lower ODI (p =0.01) in association with grade 3 in comparison with other grades. Conclusion: It is worthy to note that for patients who are to undergo lumbar discectomy, surgery has to be done with seriously considering the various factors that influence the clinical outcomes, and to brief it, patients with low back pain 8 months, lateral disc, Body mass index (BMI) 30, L5-S1disc, degeneration grade 3 and working patients have lower ODI at final follow up. Patients with low back pain 8 months, scoliosis, extruded disc and positive straight leg raising test (SLRT) have lower radicular visual analogue scale( VAS) and patients with extruded disc have lower low back pain VAS at final visit.