Zatrditev po herniaciji ledvenega diska L4-L5 s poprejšnjo operacijo in brez nje
Fusion in disc herniation at L4-L5 level with or without previous surgery

slovenian

2004

volume 73, issue 4

Slovensko zdravniško društvo
(Obvezni izvod spletne publikacije)

Background. The results of treatment in patients with transpedicular instrumented or interbody cage fusion for lumbar disc extrusions at L4-L5 level were retrospectively analyzed. The goal was to determine whether comparable clinical outcome can be achieved in cases with and without previoussurgery. Methods. Ten patients who had first symptomatic acute massivedisc herniation underwent herniotomy, posterior decompression as necessary, and fusion (Group A). Nine patients with recurrent disc herniation treated 6 years (mean, range 4 months to 14 years) earlier for the same disease were reoperated and fused because of worsening of the symptoms (Group B). At final follow-up of at least 2 years the patients were asked to estimatetheir low back and leg pain as well as their activity level on a visual scale, and to fill-in the Oswestry questionnaire. Clinical and radiological evaluation was performed using modified scoring system of the Japanese Orthopaedic Association (JOA) and score after Tria. Overall clinical results were assessed using the modified Stauffer-Coventry's evaluating criteria. Results. Patients in Group A were doing better than those in Group Baccording to low back pain (p < 0.01), leg pain (p = 0.01), and Oswestry questionnaire (p < 0.05). However, the results were not significantly different if measured by the score of Tria, JOA and activity level (p > 0.05; two group t-test). 8 patients of Group A and 3 patients in Group B achieved anoverall satisfactory result. Conclusions. Despite the groups were small for statistical analysis, the results of the study suggest that patients undergoing fusion for massive disc herniation atL4-LS level may do better if being fused at the time of primary procedure.

15.05.2023