Đánh giá kết quả phẫu thuật vi phẫu lấy nhân đĩa đệm thoát vị điều trị thoát vị đĩa đệm cột sống thắt lưng - cùng tại Bệnh viện Đa khoa tỉnh Thái Bình năm 2020-2022

Abstract

Objective: To describe the clinical, imaging characteristics and evaluating the surgical outcomes of patients with lumbar-sacral disc herniation who underwent microsurgical discectomy. Subject and method: A prospective descriptive study was conducted on 54 patients diagnosed with lumbar-sacral disc herniation who underwent microsurgical discectomy at the Department of Neurosurgery-Spine Surgery, Thai Binh General Hospital, from January 2020 to December 2022. Result: The majority of patients were of working age under 60 years (90.8%), with a mean age of 40.36 ± 12.29 years. Male patients accounted for 66.7% and female patients 33.3%. Preoperative conservative treatment was recorded in 98.1% of cases, of which 72.2% lasted more than 3 months. Central–paracentral herniation was observed in 77.8% of patients, while protrusion type was seen in 5.6% (3 cases). The most common herniation levels were L4–L5 (55.5%) and L5-S1 (38.9%), with the lowest rate at L3–L4 (5.6%). Disc degeneration was predominantly Pfirrmann grade III (64.8%). Postoperative pain reduction (VAS): Low back pain: preoperative 5.26 ± 1.30,  postoperative 2.42 ± 0.64, 6 months 1.16 ± 0.60. Leg pain: preoperative 7.16 ± 1.17, postoperative 2.34 ± 0.58, 6 months 0.98 ± 0.58. Functional improvement assessed by ODI: Preoperative 56.64 ± 1.55, postoperative 28.66 ± 8.50, 6 months 9.12 ± 7.80. According to Macnab criteria at 6 months: good and excellent results in 98.1%, fair in 1.9%, and no poor outcomes. The mean hospital stay after surgery was 4.15 ± 1.06 days. Complications included 1 case of dural tear (1.9%) and 2 cases of superficial wound infection (3.7%). Conclusion: Microsurgical discectomy for lumbar–sacral disc herniation is a safe and effective treatment, providing significant pain relief, functional recovery, short hospital stay, and a low rate of complications.