Outcome of Lumbar Minidiscectomy at OM Hospital – a series of 220 cases

IntroductIon: Lumbar disc surgery constitutes a major portion of neurosurgical practice and has come a long way since its first description by Dandy in 1929. Surgical options for lumbar disc herniation (LDH) ranges from open lumbar laminectomy and discectomy to percutaneous discectomy, however lumbar minidiscectomy introduced by R.W. William in 1980s is being widely practiced with good outcome. The objective of this study is to analyse the effectiveness of lumbar minidiscectomy in treatment of lumbar disc prolapse. Methods: It is a prospective study of 220 cases who underwent lumbar minidiscectomy at OM Hospital and Research Center, Chabahil, Kathmandu, Nepal over a period of 8 years. Patients who underwent either laminectomy or bilateral fenestration were excluded. Overall outcome was measured using Prolo Functional and Economic Scale. Results: Out of 220 consecutive patients operated for lumbar disc herniation, the commonest level involved was L4/L5 followed by L5/S1.High lumbar disc prolapse was found in 4% whereas multilevel disc prolapse was detected in 7% cases. About 81% patients had immediate improvement in radicular pain and ambulation was commenced from the first post operative day. Overall surgical complications included dural tear in 3.2% and discitis in 5% cases. At 3 months, the outcome was measured by Prolo Functional and Economic Scale. 97% had good to excellent outcome and were able to join their previous job. Recurrence was found in 2 patients. Conclusion: Lumbar minidiscectomy still remains a standard surgical technique for symptomatic lumbar disc herniation and produces excellent result with minimum resources and post-operative complications.