Abstract: Background: Lumbar disc herniation is a common orthopedic challenge warranting surgery in special situations. Lumbar discectomy is said to provide considerable relief when performed in early stages of the disease. The present study was carried out to evaluate the outcomes of lumbar discectomy based on duration of sciatica in a single institution setting among south Indian population.
Methods: In this prospective study, 50 patients with lumbar herniation were divided into 3 sub cohorts accordingly to the duration of sciatica. All these 50 patients were analysed clinically and the diagnosis confirmed with MRI and underwent laminectomy and discectomy. They were scored with ODI questionnaire preoperatively and postoperatively on 10th day, 3rd month, 6th month and 1 year.
Results: Patients in all the sub cohorts showed improvement following the surgery but patients with duration of sciatica less than 12 months showed significant improvement than patients with duration of sciatica more than 12 months. As the duration of sciatica increases the functional outcome of the surgery reduces.
Conclusion: The duration of sciatica has a significant predictive value on the functional outcome of laminectomy and discectomy. If the duration of sciatica increases the surgical outcome is poor. There are complications associated with surgical intervention which has to be emphasised while selecting the patient for the same. In view of the favourable natural course of herniation of lumbar disc and possible complications associated with surgery, most authors recommend a minimum period of conservative management for 2 months. We recommend not to exceed 12 months of conservative management as the risk of poor functional outcome increases significantly after that.
