Mădălina Duceac (Covrig), Lucian Eva, Marius Gabriel Dabija, George Stoica, Daniela Druguș, Letiția-Doina Duceac, Doina-Carina Voinescu
Abstract
Lumbar disc herniation is a population and socio-economic health problem affecting patients worldwide. More than half of adults worldwide suffer from low back pain at some point in their lives, with varying degrees of severity, frequently associated with sciatic symptoms. The multifactorial mechanism of low back pain has not yet been fully elucidated and is aggravated by mechanical, traumatic, inflammatory factors and osteoporosis. Low back pain leads over time to disability and decreases quality of life. Material and method: Our research was carried out as a retrospective epidemiological study including a group of 944 patients with lumbar disc herniation admitted in the 3 Neurosurgery Departments of the Emergency Clinical Hospital “Prof. N.Oblu” in Iași during the period 1 January-31 December 2022. Results: The study reveals a somewhat equal distribution in both sexes: male (466- 49.36%) and female 478 (50.64%) and higher in urban areas (60%). According to the age histogram, the group 41-60 years predominates – 428 cases (45.43%), followed by the group 61-80 years – 309 (32.72%), the group 21-40 years – 193 (20.43%), and 8 patients (0.85%) were over 80 years and 6 (0.63%) under 20 years. The most affected professions were: drivers, civil servants, dentists, commercial workers. The most common comorbidities in females were: neuro-psychiatric diseases (68%); hypertension (31%), obesity (15%), diabetes mellitus (12%), osteo-articular diseases (4%). 3 patients although presenting with SARS CoV-2 virus infection, were operated with favourable outcome. Obesity and intense physical exertion were the main risk factors in both sexes. Regarding the type of therapeutic manoeuvres in the studied group, 715 patients (75.7%) underwent surgical interventions such as: discectomies – 640 (89.5%); spondylolisthesis – 36 (5%); decompression – 17 (2.4%) and other reparative manoeuvres – 22 (3.1%). Conservative medical treatment required 10.5% – 229 patients. Referral for functional recuperative treatment was followed by 664 patients (70.3%), at the Recovery Hospital or state or private specialist outpatient clinics. At the 6-month reassessment, 56% showed complete remission and 44% partial remission of symptoms. Conclusions: The study highlights some clinico-epidemiological features of lumbar disc herniation, which influence the evolutionary profile of the condition in the group of patients. Comorbidities are also triggering factors with an unfavourable influence on the quality of life of these patients. Proper health care management must approach the patient with degenerative pathology holistically.
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