Spinal Approach for Lumbar Active Discopathy
Spinal Approach for Lumbar Active Discopathy
The study aims to study the impact on different surgical approaches for lumbar active
 discopathy. This inflammatory disease of the disc and adjacent vertebral endplates can induce
 low back pain with inflammatory-like features. Lumbar fusion is proposed to the patient when
 conservative management is not enough. This fusion can be obtained by an anterior muscle
 sparring approach or by a posterior muscle decaying approach.

 The goal with this single center retrospective study is to identify the surgical approach
 that offers to the patient the better long term functional outcome. A phone call would allow
 us to ask patients a few questions:

 -  Mcnab's criteria

 -  Roland Morris Disability Questionnaire

 The patients medical file review would also allow us to identify:

 -  the length of hospital stay for the discectomy (in days)

 -  incidence of Failed Back Surgery Syndrome

 -  incidence of redo surgeries

 -  incidence of adjacent level diseases

 -  incidence of dural tears and eventual complications (meningitis, orthostatic
 headaches,...)

 -  incidence of iliac vessels injuries and eventual complications (thrombosis, need for
 revascularisation,...)
1) The Roland-Morris Disability Questionnaire

 When your back hurts, you may find it difficult to do some of the things you normally do.

 This list contains sentences that people have used to describe themselves when they have back
 pain. When you read them, you may find that some stand out because they describe you today.

 As you read the list, think of yourself today. When you read a sentence that describes you
 today, put a tick against it. If the sentence does not describe you, then leave the space
 blank and go on to the next one. Remember, only tick the sentence if you are sure it
 describes you today.

 1. I stay at home most of the time because of my back.

 2. I change position frequently to try and get my back comfortable.

 3. I walk more slowly than usual because of my back.

 4. Because of my back I am not doing any of the jobs that I usually do around the house.

 5. Because of my back, I use a handrail to get upstairs.

 6. Because of my back, I lie down to rest more often.

 7. Because of my back, I have to hold on to something to get out of an easy chair.

 8. Because of my back, I try to get other people to do things for me.

 9. I get dressed more slowly then usual because of my back.

 10. I only stand for short periods of time because of my back.

 11. Because of my back, I try not to bend or kneel down.

 12. I find it difficult to get out of a chair because of my back.

 13. My back is painful almost all the time.

 14. I find it difficult to turn over in bed because of my back.

 15. My appetite is not very good because of my back pain.

 16. I have trouble putting on my socks (or stockings) because of the pain in my back.

 17. I only walk short distances because of my back.

 18. I sleep less well because of my back.

 19. Because of my back pain, I get dressed with help from someone else.

 20. I sit down for most of the day because of my back.

 21. I avoid heavy jobs around the house because of my back.

 22. Because of my back pain, I am more irritable and bad tempered with people than usual.

 23. Because of my back, I go upstairs more slowly than usual.

 24. I stay in bed most of the time because of my back.

 Note to users:

 This questionnaire is taken from: Roland MO, Morris RW. A study of the natural history of
 back pain. Part 1: Development of a reliable and sensitive measure of disability in low back
 pain. Spine 1983; 8: 141-144

 The score of the RDQ is the total number of items checked - i.e. from a minimum of 0 to a
 maximum of 24.

 It is acceptable to add boxes to indicate where patients should tick each item.

 The questionnaire may be adapted for use on-line or by telephone.

 2) Modified Macnab Criteria:

 Excellent: No pain, No restriction of mobility, Return to normal work and level of activity

 Good: Occasional nonradicular pain, Relief of presenting symptoms, Able to return to modified
 work

 Fair: Some improved functional capacity, Still handicapped and/or unemployed

 Poor: Continued objective symptoms of root involvement, Additional operative intervention
 needed at index level irrespective of length of postoperative follow-up
Inclusion Criteria:

 -  Patients suffering from lumbar active discopathy (MODIC 1, 2 or 3) with low back pain
 as dominant symptom and insufficiently relieved by conservative treatments

 Exclusion Criteria:

 -  Irradiated leg pain as dominant symptom

 -  Acquired symptomatic spinal canal stenosis requiring decompression

 -  Previous lumbar surgeries