Effect of Duration of Symptoms on the Clinical and Functional Outcomes of Lumbar Microdiscectomy

Effect of Duration of Symptoms on the Clinical and Functional Outcomes of Lumbar Microdiscectomy: a Randomized Controlled Trial

97 patients in 3 randomized groups were treated by Microdiscectomy for lumbar disc herniation; Group A was operated at 6 weeks of symptoms, Group B at 3 months and group C at 6 months. These patients were followed for 3 years for the clinical and functional outcomes.

150 patients were enrolled in this study and only 97 patients were finally analyzed for primary outcomes measures of Oswestry disability index and Roland-Morris Questionnaire and secondary outcome measures of Visual analogue scale for back pain and leg pain as well as length of hospital stay and time to return for daily activities. Assessments done at different periods of 2 weeks, 3 months, 6 months, 1year, 2 years and 3 years.

Inclusion Criteria:

• Age more than 18 years
• Disc herniation of L3-4, L4-5 or L5-S1
• MRI showed disc protrusion or extrusion with nerve root compression corresponding to clinical features.

Exclusion Criteria:

• Spondylolysis or spondylolisthesis.
• Spinal deformity like scoliosis.
• Previous spinal surgery or infection.
• Cauda equina syndrome.
• Lumbar segmental instability on dynamic radiograph: translation more than 3 mm or change in angulation more than 10 degrees
• Smoking
• Diabetes Mellitus
• Disc herniation other than levels L3-L4, L4-L5 and L5-S1
• More than single level disc hernaition.
• Body mass index 30 or more than 30
• Contained disc herniation by MRI