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2022, Number 1

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Revista Cubana de Ortopedia y Traumatología 2022; 36 (1)

Clinical profile of patients with inter vertebral disc disorders

Joseph N, Hegde A, Shenoy S, Bhanu TP, Aslam H, Kumar V, Bhargava A

Language: English
References: 30
Page: 1-18
PDF size: 397.25 Kb.


ABSTRACT

Introduction: Intervertebral disc disorders (IDDs) are being commonly observed nowadays among the young and middle aged population.
Objectives: This hospital record based study was done to study the risk factors, clinical presentation, imaging findings and management practices among patients with all types of IDDs.
Methods: A validated proforma was used to obtain information of patients confirmed with IDDs over the past three years.
Results: Mean age at onset of disc disorders among the 219 patients was 44.7±14.2 years. History of poor exercising habits were present among 72(32.9%) patients. The most common site of disc involvement was L4-L5 [151(68.9%)]. 143(65.3%) patients had single site disc involvement. The most common clinical symptom was lower back pain [180(82.2%)]. Nerve root compression was present among 154(70.3%) patients. Disc bulge, protrusion, extrusion and sequestration were present among 116(53%), 90(41.1%), 52(23.7%) and 4(1.8%) patients respectively. Age at onset >65 years (p=0.035), age at onset ≤55 years (p=0.004) and history of direct impact to the neck region (p=0.017) were associated with disc prolapse at L2-L3 level, L4-L5 level and C5-C6 level respectively, among patients with single site disc involvement. Risk of multiple level disc involvement was found to increase after 35 years (p<0.001). It was seen more involving cervical vertebrae (p=0.0068). Lumbar (p<0.0001) and lumbosacral vertebrae (p<0.0001) involvement were seenmore among patients with single site disc involvement. NSAIDs [155(70.8%)] were the most the commonly used medication. Microdiscectomy was done among 35(76.1%) out of the 46 patients who underwent surgical management.
Conclusions: Exercising habits need to be encouraged among people for the prevention of IDDs. The various high risk groups identified in this study need to be periodically screened for IDDs.


REFERENCES

  1. Gupta R, Mahajan S, Dewan D. An epidemiological study of low back pain in a tertiary care hospital of Jammu, Jammu and Kashmir, India. Int J Res Med Sci. 2017;5:835-9.

  2. Anwar BS, Shahed KB, Nasrin S, Ferdush J. Outcome of Primary Discectomy in Lumbar Intervertebral Disc Prolapse. Ortho & Rheum Open Access J. 2019;13:555872.

  3. Alshehri AK, Alshehri TK, Alyali SA, Alshahrani AA, Alshehri SH. Awareness of disc herniation among general population in Aseer province, Saudi Arabia. J Family Med Prim Care. 2019;8:1159-63.

  4. Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am. 1990;72:403-8.

  5. Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med. 1994;331:69-73.

  6. Sabreen S, Reddy AD, Divya T, Kishore P, Prasad LN, Kumar SD, et al. A Study On Laminectomy, Discectomy And Conservative Management For Prolapsed Intervertebral Disc And Assessment Of Recurrent Disc Herniation. IOSR Journal of Pharmacy. 2018;8:17-23.

  7. 7 . Prasad R, Hoda M, Dhakal M, Singh K, Srivastava A, Sharma V. Epidemiological Characteristics Of Lumbar Disc Prolapse In A Tertiary Care Hospital. The Internet Journal of Neurosurgery. 2005 [cited 01/12/2020];3(1). Available at: Available at: https://ispub.com/IJNS/3/1/5615

  8. Seidler A, Bolm-Audorff U, Siol T, Henkel N, Fuchs C, Schug H, et al. Occupational risk factors for symptomatic lumbar disc herniation; a case-control study. Occup Environ Med. 2003;60:821-30.

  9. Vucetic N, de Bri E, Svensson O. Clinical history in lumbar disc herniation: A prospective study in 160 patients. Acta Orthopaedica Scandinavica. 1997;68:116-20.

  10. Gugliotta M, da Costa BR, Dabis E, Theiler R, Juni P, Reichenbach S, et al. Surgical versus conservative treatment for lumbar disc herniation: a prospective cohort study. BMJ Open. 2016;6:e012938.

  11. Prakash A, Sharma AK, Kumar M. Prolapse Lumber Intervertebral Disc: An Institution Based Prospective Study. Int J Med Res Prof. 2016;2:332-5.

  12. Hao D, Duan KD, Liu T, Liu J, Wang W. Development and clinical application of grading and classification criteria of lumbar disc herniation. Medicine 2017;96:e8676.

  13. 13 . Janardhana AP, Rajagopal, Rao S, Kamath A. Correlation between clinical features and magnetic resonance imaging findings in lumbar disc prolapse. Indian J Orthop. 2010;44:263-9.

  14. Luoma K, Riihimaki H, Raininko R, Luukkonen R, Lamminen A, Viikari-Juntura E. Lumbar disc degeneration in relation to occupation. Scand J Work Environ Health. 1998;24:358-66.

  15. Kelsey JL, Githens PB, White AA 3rd, Holford TR, Walter SD, O'Connor T, et al. An epidemiologic study of lifting and twisting on the job and risk for acute prolapsed lumbar intervertebral disc. J Orthop Res. 1984;2:61-6.

  16. Miwa S, Yokogawa A, Kobayashi T, Nishimura T, Igarashi K, Inatani H, et al. Risk factors of recurrent lumbar disk herniation: a single center study and review of the literature. J Spinal Disord Tech. 2015;28:e265-9.

  17. Heliovaara M, Knekt P, Aromaa A. Incidence and risk factors of herniated lumbar intervertebral disc or sciatica leading to hospitalization. J Clin Epidemiol. 1987;40:251-8.

  18. Ala-Kokko L. Genetic risk factors for lumbar disc disease. Ann Med. 2002;34:42-7.

  19. 19 . American Association of Neurological Surgeons. Herniated Disc. [Cited 1 Dec 2020]. Available at: Available at: https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Herniated-Disc

  20. Humphreys SC, Eck JC. Clinical evaluation and treatment options for herniated lumbar disc. Am Fam Physician. 1999;59:575-82.

  21. Pande K. The Use of Passive Straight Leg Raising Test: A Survey of Clinicians. Malays Orthop J. 2015;9:44-8.

  22. Shakeri M, Yarandi KK, Haddadi K, Sayyahmelli S. Prevalence of abdominal aortic aneurysm by Magnetic Resonance Images (MRI) in men over 50 years with low back pain. Rawal Medical Journal. 2009;3:1-3.

  23. Boden SD, Wiesel SW. Lumbar spine imaging: role in clinical decision making. J Am Acad Orthop Surg. 1996;4:238-48.

  24. Rattanatharn R, Sanjaroensuttikul N, Anadirekkul P, Chaivisate R, Wannasetta W. Effectiveness of lumbar traction with routine conservative treatment in acute herniated disc syndrome. J Med Assoc Thai. 2004;87:S272-7.

  25. Haddadi K. Outlines and Outcomes of Instrumented Posterior Fusion in the Pediatric Cervical Spine: A Review Article. J Pediatr Rev. 2016;4:e4765.

  26. Deyo RA, Diehl AK, Rosenthal M. How many days of bed rest for acute low back pain? A randomized clinical trial. N Engl J Med. 1986;315:1064-70.

  27. Konstantinou K, Dunn KM. Sciatica: review of epidemiological studies and prevalence estimates. Spine. 2008;33:2464-72.

  28. Gibson JN, Waddell G. Surgical interventions for lumbar disc prolapse. Cochrane Database Syst Rev. 2007;1:CD001350.

  29. Ng LC, Sell P. Predictive value of the duration of sciatica for lumbar discectomy. A prospective cohort study. J Bone Joint Surg Br. 2004;86:546-9.

  30. Sabnis AB, Diwan AD. The timing of surgery in lumbar disc prolapse: A systematic review. Indian J Orthop. 2014;48:127-35.




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