Meysam AbolmaaliIran University of Medical Sciences, Iran
Title: Evaluating predictive value of preoperative clinical and imaging findings on the short-term outcome of surgery in patients undergoing lower lumbar discectomy
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.
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.