Correlation of Canal Dimension with Neurological Status and Surgical Outcome in Lumbar PIVD: A Recent Study

Introduction: Symptomatic lumbar PIVD is a leading cause of disability and absence from work. A disc herniation’s symptom is determined by a number of factors, including the disc’s level, point, and the percentage canal compromise caused by the disc, among others. The results of a prospective study on the relationship between spinal canal dimension, neurological status, and surgical outcome in lumbar PIVD are presented. Whereas lumbar disc herniation in adults is primarily caused by degenerative disc disease, as evidenced by operative findings and routine pathological examination of specimens removed, often with large sequestrated fragments, disc herniation in adolescents is typically caused by severe injury.

Methods and Materials: From May 2011 to December 2015, 41 patients were followed for an average of one year. Patients with cauda equina syndrome, back or leg pain that persisted for more than 6 weeks despite conservative treatment, and patients with progressive motor weakness and leg symptoms were included in the study. Patients over the age of 60, as well as those with traumatic disc prolapse and spondylolethesis with disc prolapse, were excluded from the study. An MRI scan was used to determine the dimensions of the spinal canal after a prolapsed disc in the AP and transverse dimensions. Symptoms were assessed using the JOA SCORE and the ODI SCORE at the preoperative, 1, 3, 6, and 12 month follow-up visits. To create the correlation, the Pearson correlation coefficient was used. The average age of the patients was 37.62 years. The mean anteroposterior canal dimension was 6.72mm in AP and 14.20mm in transverse. The mean preoperative JOA score was (7.463.45) and (10.754.26) in group 1 and 2 respectively with a p-value of 0.068, but the postoperative JOA score was almost identical (27.093.4) and (27.375.09) in both groups with a p-value of 0.855. The mean preoperative JOA score in the transverse group was (6.454.05) and (11.22.14) in groups 1 and 2, respectively, with a p-value of 0.004, and the postoperative JOA score was (6.454.05). The p-value for (27.094.78) and (28.13.1) in two groups was -5.78. The only group with a significant p-value of 0.004 was the preoperative transverse group. The mean preoperative ODI score in the AP group was higher (377.11) in group 1 than in group 2 (30.629.13), with a p-value of 0.39, but the final postoperative ODI score (9.310.8) and (8.879.9) was nearly the same in both groups, with a p-value of 0.926. The mean preoperative ODI score in the transverse group was (37.277.55) and (31.668.52) in the longitudinal group. group 1 and group 2 with p-values of 0.122, respectively, but the final postoperative ODI score (11.3612.85) and (6.74.76) was nearly identical in both groups with p-values of 0.294. Because the pvalues in both groups are insignificant, it is safe to conclude that the decrease in canal dimension has no bearing on the patients’ symptoms.

Conclusion: Based on the findings presented above, it is safe to conclude that the canal compromise caused by the prolapsed disc is unrelated to the patient’s symptoms. Other factors, such as the position of the prolapsed disc in relation to the nerve root, the stage of disc herniation, and so on, are important in the overall symptomatology of a prolapsed disc.

Author (s) Details

Shafiq Hackla
Department of Orthopaedics, GMC Jammu, India.

Farid Hussain Malik
Department of Orthopaedics, GMC Jammu, India.

Saumyjit Basu
Department of Orthopaedics, GMC Jammu, India.

Anil Kumar Gupta
Department of Orthopaedics, GMC Jammu, India.

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