Publication:

Functional outcome of fenestration discectomy in discogenic lumbar canal stenosis

Background Annual incidence of significant disc herniation causing sciatica ranges from 14% to 15%. Inspite of various treatment modalities available, fenestration discectomy still remain treatment of choice for discogenic lumbar canal stenosis. The objective of our study is to assess functional outcome and complications associated with fenestration discectomy in patients of discogenic lumbar canal stenosis.

Methods Thirty two patients who had unilateral radicular pain with clinicoradiologically confirmed posterolateral disc herniation and who failed to respond to conservative management were treated surgically by fenestration discectomy. Outcome was assessed using Oswestry disability index at 6 months follow up.

Results Patients with neurological deficits underwent fenestration discectomy with complete relief of radicular pain in 17 patients and mild reduction in 5 patients on follow up. 23 patients had recovery from motor symptoms and 25 patients had recovery from sensory symptoms whereas 9 patients still had motor weakness and 7 patients still had sensory deficit. Oswestry disability index (ODI) score used for functional outcome at 6 months postoperatively showed 63% of the patients were having 0 to 20 ODI score with minimal disability, 34% of the patients had score of 21 to 40% with moderate disability, and 3% were having 41 to 60% ODI score with severe disability. One patient had dural tear and two patients had post-operative discitis.

Conclusions Fenestration discectomy is an excellent surgical option for discogenic lumbar canal stenosis. Fenestration discectomy is an easy, economical and effective means of treating lumbar disc prolapse with minimal acceptable complications.