The Analysis Of Long-Term Outcome Of Discectomy

Objective To review and analyze the long-term curative effect on patients after discectomy.Method From 1988 to 2003, there were 710 cases with complete clinical data who have an operation because of LDH in the department of orthopedics of the hospital pertain to medical college of Qingdao University. Adopting questionnaire investigating way to collect the data of evaluating curative effect by telephone, letter and out-patient callback. According to the follow-up time, all patients were divided into three groups, namely middle-term follow-up(3-4 years), long-term follow-up(5-9 years) and super long-term follow-up(10 years are above). To analyze the clinical effect according to the assessment scale proposed by the Japanese Orthopaedic Association(JOA) and the China Orthopedics Academic Association. Investigatings was learned by statistics. At the same time, something was down to compare the improvement rate of the patients with different follow-up term.Result Acording to the assessment scale proposed by the China Orthopedics Academic Association, the total good rate of the 273 cases was 85.71%, the good rate of 3~4-year, 4~9-year and over 10-year follow-up was respectively 95.58%, 85.82% and 75%. Outcomes was analyzed by statistics, the difference between 3~4-year follow-up and 4~9-year follow-up, 3~4-year follow-up and over 10-year follow-up was distinguished (P<0.05, P<0.01) ,but the difference between 4~9-year follow-up and over 10-year follow-up was not distinguished(P>0.05). Acording to the assessment scale proposed by the JOA, the total average score was 9.32 before operation, 24.15 after operation, the average score of 3~4-year, 4~9-year and over 10-year follow-up was respectively 10.56% 9.30 and 9.51 before operation, 24.75 22.43 and 21.64 after operation.Analysis of outcome among groups, the result is similar to the above.Conclusion After discectomy, the patients with a herniated lumbar disc had a obvious improvement in function and satisfaction, at the same time, there was a trend of descent in curative effect along with time went by. The key to increase the long-term curative effect is as follow: to definite the diagnosis firstly;strictly judge the cases need to be treated surgically secondly, strictly follow the surgical operation rules;finally, think much of scientific practice after surgery.