CASE SERIES OF 325 PATIENTS WITH LUMBAR DISC HERNIATION OPERATED ON AN EMERGENCY BASIS

Abstract

ABSTRACT Lumbar disc herniation (LDH) is a common disease in medical practice, with high costs of medical care, long-term disability, and worsening quality of life. Demographic and case series studies are important for understanding diseases’ natural history and associated risk factors. Analyze the clinical and demographic characteristics of a case series of 325 LDH operated on in a neurosurgery service in southern Brazil. This study enrolled patients with lumbar disc herniation who underwent surgery. Clinical and epidemiological data were retrieved from medical records and retrospectively characterized. Three hundred and twenty-five patients were selected for analysis. 51% of patients were men, with an average age of 46. Hypertension and smoking were the most prevalent comorbidities, with 16% and 21% respectively. Radicular pain was the most common clinical presentation (78% of cases). 92% of patients had median or postero-lateral LDH; the remaining were foraminal or extra-foraminal. Infectious complications occurred in 2.4% of cases, and liquoric fistula in 1.2%. The recurrence rate at the same level was 16%. Diabetes was the only statistically significant risk factor related to LDH reoperation. LDH is a prevalent pathology. The most common symptom is radicular pain due to median or posterolateral LDH. Initial management involves analgesia and other nonsurgical therapies. Lumbar microdiscectomy is performed when non-surgical management is unsuccessful. Diabetes is an important risk factor for the recurrence of LDH. Level of Evidence III; Retrospective study.