Ammar Ahmed, Alwadei Ali, Al Hayek Ali, Alabbas Faisal M, Almatrafi Faisal Rashed, Elshawarby Mohammed
Department of Neurosurgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Department of Pathology, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Asian J Neurosurg. 2020 Aug 28;15(3):545-553. doi: 10.4103/ajns.AJNS_193_20. eCollection 2020 Jul-Sep.
Prolapsed lumbar disc is one of the most frequent diseases, which is usually presented by motor and sensory deficits. Consistency of herniated disc may play a significant role in surgical treatment and postoperative improvement. The objective of this study is to assess whether the histopathological degeneration in the sample of lumbar discs operated on is correlated to clinical variables and surgical outcomes.
A randomized double-blind prospective study of lumbar disc prolapse cases over a period of 24 months was done. Forty cases were initially included in the study. All the included cases with a scheduled lumbar discectomy in the Department of Neurosurgery, King Fahd University Hospital, Al-Khobar, Saudi Arabia, during this period were examined histologically.
Finally, 21 patients were only considered in this study due to loss of follow-up of the other 19 patients; of these 21 patients, 18 were male and 3 were female. The youngest patient was 32 years old, and the oldest was 72 years old. There is no significant correlation between the major histopathological changes of the prolapsed discs and the clinical findings of low back pain (correlation coefficient = 0.058, < 0.8), duration of sciatica (correlation coefficient = -0.337, < 0.1), paresthesia (correlation coefficient = 0.111, < 0.6), motor weakness (correlation coefficient = 0.274, < 0.2), and reflex (correlation coefficient = 0.081, < 0.7). Meanwhile, the correlation coefficient between numbness and histopathological degeneration score (HPDS) is not defined because all reported cases were presented with numbness.
There is no significant correlation between the histopathological changes of the prolapsed discs and some clinical findings. Moreover, the different types of prolapsed discs' histopathological changes have no impact on the outcome of the surgery. We also concluded that the disc material undergoes certain degenerative processes with age.
腰椎间盘突出症是最常见的疾病之一，通常表现为运动和感觉功能障碍。椎间盘突出物的一致性可能在手术治疗和术后恢复中起重要作用。本研究的目的是评估接受手术的腰椎间盘样本的组织病理学退变是否与临床变量和手术结果相关。
对腰椎间盘突出症患者进行了为期24个月的随机双盲前瞻性研究。最初纳入研究40例病例。在此期间，沙特阿拉伯胡拜尔法赫德国王大学医院神经外科所有计划行腰椎间盘切除术的纳入病例均进行了组织学检查。
最后，由于另外19例患者失访，本研究仅纳入21例患者；这21例患者中，男性18例，女性3例。最年轻的患者32岁，最年长的72岁。椎间盘突出的主要组织病理学变化与腰痛的临床症状（相关系数=0.058，P<0.8）、坐骨神经痛持续时间（相关系数=-0.337，P<0.1）、感觉异常（相关系数=0.111，P<0.6）、运动无力（相关系数=0.274，P<0.2）和反射（相关系数=0.081，P<0.7）之间均无显著相关性。同时，麻木与组织病理学退变评分（HPDS）之间的相关系数未定义，因为所有报告病例均有麻木症状。
椎间盘突出的组织病理学变化与一些临床症状之间无显著相关性。此外，不同类型的椎间盘突出组织病理学变化对手术结果无影响。我们还得出结论，椎间盘材料会随着年龄的增长而经历一定的退变过程。
