http://www.loc.gov/mods/v3 http://www.loc.gov/standards/mods/v3/mods-3-2.xsd
ABSTRACT: Low back pain constitutes a major socio-economic and medical problem, affecting 80 percent of the population at some point in their lives. Although there has been no population based study in Nepal, the fact that a third of the total Neurosurgical out-patient department (OPD) attendance at the Bir Hospital are due to disc diseases indicates that it is an equally common problem in Nepal. This prospective study of 60 consecutive patients operated on for a herniated lumbar disc between 13 April 1996 to 12 April 1997, at the Neurosurgical Unit, Bir Hospital and the Everest Nursing Home by the same Neurosurgeon, aims to assess the medium term clinical outcome of lumbar disc surgery. It was possible to follow-up all the patients up to three months post operatively. The most commonly affected age group was 25 to 55 years (78.13%), belonging to all professionals. Males were more affected than female (1.6:1). The most common presenting complaint was back pain (93%). Majority of the patients (55%) were diagnosed by radiculography. In most of the patient (73%) microdisectomy was performed and the most commonly affected disc level L4-5(59%). Majority of the patients (67%) were ambulated from the very first postoperative day and most of them (53.3%) were discharged in the second postoperative day. The complication encountered in 13 percent of the patient, which were managed conservatively. The subjective clinical outcome at the end of 3 months revealed 86.7% excellent and 13.3% good results. Similarly The Prolo functional Economic Outcome Rating Scale showed 97% good and 3% moderate results. With strict patients selection and appropriate surgical procedure favourable clinical outcome can be achieved in symptomatic disc disease thereby reducing morbidity and economic loss related to it.