Clinical outcomes and MRI changes after microdiscectomy performed for a lumbar herniated disc (Doctoral thesis)

Παπαναστασίου, Ευάγγελος Ι.

To evaluate the associations between pain, disability, quality of life and Magnetic ResonanceImaging (MRI) findings preoperatively and five years postoperatively after lumbar microdiscectomy(LM).Methods: Ninety one patients who underwent LM by the same surgeon participated in this prospectivestudy. Pain, disability and quality of life were measured and compared with validated questionnairespre- and up to five years postoperatively. A subgroup of 61 patients performed both preoperative andfive-year postoperative MRI. In this group, associations between clinical and radiological outcomeswere recorded.Results: In all assessment questionnaires there was a significant improvement in the firstpostoperative month compared with preoperative data, which lasted up to one year post discectomy.After that improvement was statistically significant (p<0.05) but without clinical importance. Inpostoperative MRI the morphology of the operated disc was improved; however facet joints’ arthritisand degeneration of the operated and caudal adjacent disc were worse. These changes wereassociated with age at the time of surgery. Preoperatively patients without Modic changes had similarclinical status with those presenting with Modic 1 and had better clinical results. There was nodifference in patients presenting with Modic 2 and 3 changes. Preoperative Pfirrmann IV and V gradeswere associated with worse clinical outcomes up to one year postoperatively compared with grades Iand II.Conclusion: Significant clinical improvement was recorded from the first postoperative month to thefirst postoperative year; no clinical improvement was noticed later on. Higher Pfirrmann and Modicchanges were associated with worse clinical outcomes.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Subject classification: Οσφυική μοίρα της σπονδυλικής στήλης
Keywords: Μεταβολές στη μαγνητική τομογραφία,Μικροδισκεκτομή οσφυϊκής μοίρας σπονδυλικής στήλης,Κλινικά αποτελέσματα,Πενταετής μετεγχειρητική παρακολούθηση,Lumbar microdiscectomy,MRI changes,Clinical outcomes,5-year follow up
Appears in Collections:Διδακτορικές Διατριβές

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