Microlumbar discectomy(preservation of the ligamentum flavum): clinical and radiological analysis

ABSTRACTHalil İbrahim GündüzMicrolumbar discectomy (preservation of the Ligamentum flavum): Clinical andRadiological analysisThe most common reason of postoperative back pain and radiculopathy in lumbardiscectomy is the epidural fibrosis and recurrent herniation. The effects of epidural fibrosisafter discectomy are not only a problem between the patient and the surgeon, but alsodamages economic and socioeconomic ally.Eighty patients with unilateral lumbar discectomy were randomly divided into twogroups. Group 1 patients underwent classic microlumbar disecectomy and group 2 patientsunderwent the same procedure but with preservation of ligamentum flavum. Visual analogpain scale (VAPS) scores, Ostwestry scale scores were recorded preoperatively and six?smonths postoperatively. Differences preoperative and postoperative findings for each groupwere statistically compared using the t test. Magnetic resonance imaging was done at sixmonths evaluate the extent of postoperative fibrosis and scarring grade was determined for allpatients. Prolo economic and functional scale scores was determined in each groups atpostoperative sixth months. The groups? findings for these were analyzed with Chiquare test.In two groups clinical outcomes were satisfactory but clinical results of group 2 werestatistically better than group 1. Group 2 (preserved Ligamentum) demonstrated significantlyless local fibrosis at postoperative 6th month. We believed that this protective surgicaltechnique can be reducing fibrosis related complication after lumbar disc surgery.Keywords: Epidural fibrosis, Ligamentum flavum, Microlumbardiscectomy, Postoperative fibrosis.2