Evaluation of Prognostic Factor and Pain Intensity Following Thoracolumbar Disc Surgeries

Thoracolumbar Junction (TLJ) is a transitional zone between the rigid thoracic spine and the flexible lumbar spine. Diagnosis and treatment of herniated discs pertaining to this spinal region is difficult owing to its unique anatomy has challenges to spine and orthopedic surgeons and neurosurgeon. There is not definite approach to TLJ surgeries, with different controversies surrounding each. Therefore, the outcomes and complications associated with different approaches were examined in this study. Methods and Materials/Patients: After being approved by ethics committee of Tabriz university of medical sciences Forty-nine patients undergoing TLJ disc surgeries during 2012-2016 were studied in three Iranian hospitals, i.e. Imam Reza and Shohada hospitals in Tabriz, and Azarbaijan Hospital in Urmia. Patients were examined in terms of gender, age, BMI, surgical level, number of surgical surfaces, lower extremity pain, back pain, paresthesia of limbs and perineum, weakness of lower limbs, sphincter disorder, surgery types including laminectomy+festectomy+discectomy with or without Fusion and with or without Fixation. From Forty-nine patients, 22 patients were male and 27 were female. The mean age was 46.75±6.83. Nine patients had severe lower extremity pain (VAS≥6) and 40 patients had mild pain (VAS<6), which corresponded to postoperative limb pain: 24 patients reported severe pain and 25 mild pain, which lasted over 6 months. There was no significant relationship between fusion and lower extremity pain. Based on the results of this study, which examined the factors affecting prognosis and severity of pain after thoracolumbar discs, spinal cord manipulation should be avoided due to limited circulation of the spinal area.