2025, Number 3
Clinical improvement in patients postoperatively treated by conventional microdiscectomy of the lumbar spine for degenerative disc disease
Full text
10.35366/120094
Language: Spanish
References: 19
Page: 187-196
PDF size: 230.09 Kb.
ABSTRACT
Introduction: degenerative diseases of the lumbar spine are mainly caused by the degeneration of the intervertebral discs or also by the so-called degenerative disc disease (DDD) is a chronic clinical entity that causes a great socioeconomic impact. Its main clinical symptom is low back pain, which can affect one or several segments of the axial axis in this area, it is one of the main causes of functional limitation causing disability, as well as an increase in the patient's morbidity. DDD has a multifactorial etiology, with both genetic and environmental influences. Intervertebral disc problems are a common cause of low back pain, discogenic and radicular pain. The goals of management of DDD with active symptoms include the preservation of function with pain control. Conservative management is comprehensive and continues to be the best treatment, although the success rate is not stable, managing wide effectiveness margins between 18 and 80%. Surgical management for herniated discs has been described as a third line of the same management after failure of conservative management, this includes conventional discectomies, as well as minimally invasive, by laminectomies or hemisemilaminectomies, disc arthroplasty, release with or without lumbar fusion. Surgical indications range from failure of conservative management with intense pain that does not respond to analgesics to neurological compromise such as paresthesias, loss of strength in the extremities or cauda equina signs. The primary indication for the surgical procedure is to provide a faster clinical improvement. Conventional discectomy in carefully selected patients with radiculopathy due to lumbar disc herniation provides earlier relief of the acute condition than conservative management. Objective: to evaluate the clinical improvement in patients undergoing conventional lumbar spine microdiscectomy for degenerative disc disease, using the visual analogue scale and the Oswestry Disability Index one year after the intervention. Material and methods: an observational and retrospective study was carried out at the General Hospital of Mexicali, Baja California. Data were collected by reviewing the clinical records of patients diagnosed with degenerative disc disease of the lumbar spine, treated between January 1, 2022, and January 1, 2024. The objective of the study was to evaluate the clinical improvement achieved after conventional microdiscectomy in patients with symptoms of low back pain and radiculopathy, analyzing changes in pain using the visual analogue scale (VAS) and in function through the Oswestry Disability Index (ODI). Results: the study included a total of 42 patients, who met inclusion and exclusion criteria with an average age of 46.07 ± 13.4 years. The pain intensity in the preoperative VAS showed a median of 8 (IQR 3) and 2 (IQR 2.75) at 12 months postoperatively. The ODI functional scale showed a median of 24.5 points (IQR 28.2) and 3 points (IQR 4) at 12 months postoperatively. Conclusions: the appropriate statistical approach strengthens the validity of these results, placing conventional microdiscectomy as a highly effective option for patients with degenerative vertebral pathology or severe disc compressions. The notable reduction in the disability and pain scales highlights surgical success and emphasizes the relevance of a comprehensive pre- and postoperative evaluation, as well as the importance of rehabilitation, risk factor control and continuous follow-up to obtain optimal results and maintain them over time.REFERENCES
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