
Meysam Abolmaali
Iran University of Medical Sciences, IranTitle: Evaluating predictive value of preoperative clinical and imaging findings on the short-term outcome of surgery in patients undergoing lower lumbar discectomy
Abstract
The most common indications for spinal surgery
are low back pain and associated disabilities caused by disc herniation. Given
the high prevalence of low back pain, and knowledge about the influencing and
predisposing factors, the clinical and radiologic findings associated with pain
relief and postoperative recovery were evaluated in patients who underwent
bilateral lumbar discectomy. A prospective cohort study included adults with
symptomatic disc herniation in the L4-L5 and L5-S1 segments who were candidates
for bilateral discectomy. Before and after surgery, patients were evaluated for
lumbar and radicular pain and the Oswestry Disability Index (ODI) score and at
4-, 12-, and 24-week follow-up. Meanwhile, a variety of demographic, clinical,
and radiologic factors was collected and statistically analyzed. The mean age
was 41.2 years, with 22 males and 8 females. Statistical analysis revealed that
radicular pain and disability associated with low back pain significantly
decreased following surgery (P=0.001). However, there was no significant
reduction in back pain (P>0.05). Patients with a higher body mass index
(BMI) and neurological claudication had a lower reduction in radicular pain
(P<0.05). Moreover, a higher BMI and the presence of instability pain are
associated with an increased likelihood of postoperative lumbar pain relief
(P<0.01). Among the radiological variables, increased disc height was associated
with a more rapid recovery from low back disability (P=0.003). Furthermore, a
larger diameter of paraspinal muscles at the level of the herniated disc was
associated with a more rapid improvement of lower back pain (P=0.021). Finally,
we conclude that Age, BMI, neurological claudication, instability pain, and
paraspinal muscle diameter played a role in postoperative pain relief.
Increased disc height was associated with a more rapid decline in the ODI
score. Future studies with larger sample sizes are recommended.
Biography
Meysam Abolmaali has completed
his course as a general practitioner at the age of 27 years from Iran
University of Medical Sciences (IUMS), Tehran, Iran. In 2017, he began his path
by joining the Student Research Committee at IUMS. Shortly after, he awarded
the best poster in the 19th Annual Research Congress of Iranian Medical
Sciences Students (19ARCIMS). Since then, he contributed in more than twenty
publications as the first author, co-author, or correspond author. These papers
have been cited over 90 times, and his publication h-index is 5. He has been
working as a physician in emergency department and partial-time researcher,
simultaneously. Spine and discopathy is of his favourite field in the research
area.