Rashidoon Nabi Khan
Department of Neurosurgery, BangladeshTitle: Lumbar Interverterbral Disc Prolapse (PLID) surgery under spinal anaesthesia
Abstract
Background: Prolapsed lumbar intervertebral disc (PLID) is a common surgical problem in spinal and neurosurgical practice. Spinal anaesthesia for PLID surgery is becoming popular due to its cost effectiveness and avoidance of neurological injury during prone positioning under general anaesthesia.
Aim: This observational study aimed to evaluate the effectiveness of spinal anaesthesia for PLID surgery by observing surgical options based on pathological outcomes, postoperative pain, immediate functional recovery, cost effectiveness, and patient satisfaction.
Methods: The study was conducted on 4000 patients with ASA I-III grading who underwent PLID surgery at single level to two levels between January 2007 and July 2019. The perioperative events, anaesthetic complications, pace of physiological and functional recovery, and patient satisfaction were documented. Pain levels were measured using a visual analogue scale (VAS) and satisfaction levels using a verbal rating scale (VER).
Results: The highest incidence of PLID surgery was in the 36-45-year age group. Among the participants, males were 60.4% and females were 39.5%. The highest level of PLID was at L3/4 (39.0%). The mean values for per-operative blood loss in new and recurrent cases were 47.65 (±9.14) and 55.60(±13.80) respectively. Hypertension was the highest per-operative complication at 36.0%. The average hospital stay was 36-48 hours.
Conclusion: The results suggest that spinal anaesthesia is a viable option for PLID surgery for at least 2 levels, as it is cost-effective, allows for quicker recovery and minimum hospital stay, and provides patient satisfaction. These findings align with other available studies on the topic.
Keywords: intervertebral disc prolapse (PLID) surgery, spinal anaesthesia, cost effectiveness.
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