Comparative study of two skin incisions for microscopic lumbar discectomy

• Published in: World neurosurgery
• Main Authors: Hamouda, Waeel Ossama, Dr, Aladdin, Mohammed, Dr, AL-Muammar, Sarah Abdulaziz, Dr, Gari, Danya Mohammed Khalid, Dr
• Format: Journal Article
• Language: English
• Published: 2016
• Subjects: Neurosurgery; Microdiscectomy; magnetic resonance imaging; MRI; CBC; NSAID; non steroidal anti inflammatory drugs; numeric pain rating scale; NRS; complete blood count; Transverse; SD; Skin incision; Lumbar; standard deviation
• ISSN: 1878-8750
• DOI: 10.1016/j.wneu.2016.10.077

Abstract Background Microscopic lumbar discectomy is a common, minimally invasive surgery. A transverse skin incision has sound theoretical cosmetic advantages in comparison to the classic vertical incision. Objectives the study aimed to compare transverse and vertical skin incisions for microscopic discectomy regarding cosmetic outcome, postoperative pain and the provided surgical cutaneous inlet. Materials & Methods Eighty-six patients were randomly enrolled prospectively in the study, divided among a vertical incision group (V group) and a transverse incision group (T group). The maximum surgical cutaneous inlet provided was measured in two diameters. Post-operative pain was recorded using a numeric patient rating scale from 0 to 10 with 0 indicating no pain at days 1, 3 and 7 postoperatively. Cosmetic appearance of the wound was evaluated by a plastic surgeon and by the patients to fall within five categories (excellent, very good, good, fair and poor). Results In comparison to vertical incisions, transverse incisions provide similar surgical cutaneous inlets, cause higher pain scores on days 1 and 3 postoperative days but similar score on the 7th day, and ensure a significantly better wound cosmesis. Conclusion Transverse skin incision for microscopic lumbar discectomy is an applicable alternative to the classic midline or paramedian vertical incisions with better aesthetic results.