Lumbar disc herniation: Early surgery versus prolonged conservative treatment.

  • Urooj Fatimah Siddiqui Dow University of Health Sciences, Civil Hospital Karachi.
  • Muhammad Faiq Ali Dow University of Health Sciences, Civil Hospital Karachi.
  • Muhammad Asim Khan Rehmani Dow University of Health Sciences, Civil Hospital Karachi.
  • Atiq Ahmed Khan Dow University of Health Sciences, Civil Hospital Karachi.
  • Sheeraz - Dow University of Health Sciences, Civil Hospital Karachi.
  • Zeeshan - Dow University of Health Sciences, Civil Hospital Karachi.
  • M. Imran Dow University of Health Sciences, Civil Hospital Karachi.
Keywords: Early Surgical Intervention, Prolonged Conservative Treatment, Sciatica, Visual Analogue Score

Abstract

We seek to compare pain sensation after surgical and conservative treatment in patients having sciatica with lumbar disc herniation in a routine clinical setting. Objectives: To compare the outcome of early surgical intervention versus prolonged conservative treatment in patients with sciatica due to herniated lumbar intervertebral discs. Study Design: Randomized Control Trial. Setting: Department of Neurosurgery, Dow University of Health Sciences, Civil Hospital Karachi. Period: Aug 1, 2017 till May 31, 2018. Material & Methods: Data was prospectively collected from patients after taking a consent. A total of 70 patients, with 35 patients in each Group A (early surgical intervention) and Group B (prolonged conservative treatment) were included. Demographic data was presented as simple descriptive statistics giving mean and standard deviation and qualitative variables were presented as frequency and percentages. P-value of ≤ 0.05 was taken significant. Effect modifiers were controlled through stratification to see the effect of these on the outcome variable. Post stratification independent t-test was applied taking p-value of ≤0.05 as significant. Results: Mean age in group A and B was 45.18±7.64 and 42.78±5.87 years respectively. 30 (85.7%) were male and 05 (14.3%) were female in group A. 28 (80%) were male and 07 (20%) were female in group B. Mean pre and post VAS score in group A was (7.18±0.71 and 2.18±0.55) and group B was (7.78±0.34 and 3.26±0.21). Mean pre and post SF36 BP score in group A was (24.18±3.81 and 65.54±6.14) and group B was (34.29±4.91 and 68.21±5.87). Conclusion: Many patients continue to refer conservative treatment of sciatica, despite of pain but given the results of this study, early surgical intervention appears to be superior to medical management for the treatment of Sciatica with respect to patient outcome.

Author Biographies

Urooj Fatimah Siddiqui, Dow University of Health Sciences, Civil Hospital Karachi.

FCPS

Fellow of Neurosurgery

 

Muhammad Faiq Ali, Dow University of Health Sciences, Civil Hospital Karachi.

FCPS

Assistant Professor Neurosurgery

Muhammad Asim Khan Rehmani, Dow University of Health Sciences, Civil Hospital Karachi.

FCPS

Assistant Professor Neurosurgery

Atiq Ahmed Khan, Dow University of Health Sciences, Civil Hospital Karachi.

FCPS

Professor of Neurosurgery

Sheeraz -, Dow University of Health Sciences, Civil Hospital Karachi.

FCPS

Assistant Professor Neurosurgery

Zeeshan -, Dow University of Health Sciences, Civil Hospital Karachi.

FCPS

Assistant Professor Neurosurgery

M. Imran, Dow University of Health Sciences, Civil Hospital Karachi.

FCPS

Professor of Neurosurgery

Published
2020-09-10