Role of Visual Analogue Pain Score at Day 1 and 30 in Predicting Outcome after Full Endoscopic Lumbar Discectomy

Babar Shamim; Sajid  Ali; Waseem  Afzal; Muhammad  Talha; Shahzad  Inam; Liaquat Mahmood  Awan

doi:10.51253/pafmj.v75i3.12209

Authors

Babar Shamim Department of Spinal Surgery, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Sajid Ali Department of Spinal Surgery, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Waseem Afzal Department of Spinal Surgery, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Muhammad Talha Department of Spinal Surgery, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Shahzad Inam Department of Spinal Surgery, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Liaquat Mahmood Awan Department of Spinal Surgery, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75i3.12209

Keywords:

Endo discectomy, Lumbar disc herniation, Open discectomy

Abstract

Objective: To compare the change in pain score one month after full endoscopic lumbar discectomy in the patients who showed substantial improvement of pain vs those who did not at 1st post- operative day.

Study Design: Quasi experimental study

Place and Duration of Study: Department of Spinal Surgery, Combined Military Hospital Rawalpindi, Pakistan from Aug 2023 to Apr 2024.

Methodology: A quasi-experimental study was conducted that included 100 patients of prolapsed lumbar intervertebral disc. Preoperative pain assessment was done via Visual Analog Scale (VAS). Interlaminar Endoscopic Discectomy was performed in all cases. Postoperative VAS was recorded on day 1, 3, 15 and 30 and analyzed by Nonparametric Independent-Samples Mann-Whitney U test.

Results: Substantial pain relief observed in 79(79%) cases making satisfactory group while 21(21%) cases showed persistent pain from 1st postoperative day constituting unsatisfactory group. Intergroup comparison of VAS revealed significant difference (p<0.001) on postoperative day 1, 3. 15 and 30. In both groups VAS recorded on 1st postoperative day did not change significantly till day 30 suggesting the importance of VAS on 1st postoperative day as a predictor of the surgical outcome.

Conclusion: In the patients with poor outcome in terms of pain relief on 1st postoperative day following FELD, there are least chances of improvement of pain score on subsequent days. Repeat MRI may be done in such cases without further delay to rule out presence of remnant disc fragment or to find other causative factors at the site of surgery.

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