Study of Restorative Spinoplasty in Midline Decompression and Discectomy for Intervertebral Disc Prolapse

Abstract

OBJECTIVE: The objective of the study was to evaluate the role of spinoplasty in the surgical management of intervertebral disc prolapse by midline decompression and discectomy. MATERIALS AND METHODS: Our study included 30 patients diagnosed with lumbar intervertebral disc prolapse at one level between July 2018 and October 2021. The patients belonged to the age group 18–45 years and comprised both males and females. All the patients in our study were operated by fenestration and discectomy of the involved level. Intraoperatively, the spinous process was not removed at the involved level. The spinous process was cut at the base, at the insertion of interspinous ligament, retracted along with the ligament complex, and the lamina was exposed. After the decompression of neural tissues, the spinous process was anatomically restored by performing a spinoplasty. All patients were followed up postoperatively and evaluated by the Oswestry Disability Index (ODI), Visual Analog Scale (VAS), and patient satisfaction. Results: In our study, most patients had involvement of L4–5 disc (70%). Intraoperatively, satisfactory neurological decompression was achieved and all patients had relief of symptoms immediately. The mean ODI and VAS scores were 58% and 8.2 preoperatively which reduced significantly to 15.5% and 0.8 during 6 months postoperative follow-up. The patients were mobilized on the 2nd day after surgery and had a faster recovery time with good functional outcomes. Conclusion: The goal of treatment of intervertebral disc prolapse is to improve the quality of living and reduce the economic burden of the disease. Spinous process osteotomy carried out and restorative spinoplasty done after nerve decompression provided satisfactory functional outcomes.

Keywords

• discectomy
• intervertebral disc prolapse
• spinoplasty