The RELATIONSHIP OF SPINAL CANAL DIAMETER CONVERSION TO PAIN AND DISABILITIES AFTER TRANSFORAMINAL MICRODISCECTOMY SURGERY AMONG LUMBAR DISC HERNIATION

Abstrak

Introduction: Transforaminal microscopic discectomy (TFMD) is a minimally invasive procedure under local anesthesia for decompressing outer disc materials. Recently lumbar disc herniation (LDH) in association with chronic pain tends to opened surgical treatment with general anesthesia. Aim: This study aims to see the association between spinal canal diameter changes to pain and clinical disability among LDH patients experienced with TFMD. The study is an analytic observational Case-Control study conducted in Dr. Kariadi Hospital Semarang Indonesia. Numerical Rating Scale (NRS), Oswestry Disability Index (ODI), PainDetect, and disc diameter monitored Before and After TFMD. Subjects were divided into: Group TFMD1 (NRS> 2) and TFMD2 or Control (NRS 1-2); then followed up Before, Month 3, and 6 after surgeries.  Results : Fifty subjects were involved (Group TFMD1 24 subjects, TFMD2 26 subjects), of whom twenty-three showed post-surgical spinal canal diameter at the decompressed site <0.1cm, whereas 27 subjects >0.1cm. The NRS showed significant differences on both (p<0.0001), wherein the TFMD2 observed lower scale improvement changes (p<0.0001). A significant improvement in ODI scores between both (p<0.0001), wherein the TFMD2 group presented lower than TFMD1 (p<0.0001). Lowering of neuropathic pain score observed in comparison to before TFMD (p<0.0001), but statistically not significant of both (p>0.05). Discussion :TFMD with the effectiveness of spinal canal decompression regards spinal canal diameter reduction. This lead to clinical improvement of pain and disabilities, even though under local anesthesia and small incision.