ABSTRACT
Literature recommends that refractory cases with lumbar disc herniation and appropriate indications are better to be treated surgically, but do all the patients throughout the world consent to the surgery with a same disability and pain threshold? We aim to elucidate the prevalence and severity of disabilities and pain in Iranian patients with lumbar disc herniation who have consented to the surgery. In this case series study, we clinically evaluated 194 [81 female and 113 male] admitted patients with primary, simple, and stable L4-L5 or L5-S1 lumbar disc herniation who were undergoing surgical discectomy. The mean age of the pa-tients was 38.3+/-11.2 [range: 18-76 years old]. Disabilities were evaluated by the items of the Oswestry Disability Index [ODI] questionnaire and severity of pain by the Visual Analogue Scale [VAS]. Chi-square test was used to compare the qualitative variables. Severe disability [39.2%] and crippled [29.9%] were the two most common types of disabilities. Mean ODI score was 56.7 +/- 21.1 [range: 16-92]. Total mean VAS in all patients was 6.1 +/- 1.9 [range: 0-10]. Sex and level of disc herniation had no statistical effect on preoperative ODI and VAS. The scale of six was the most frequent scale of preoperative VAS in our patients. Iranian patients with lumbar disc herniation who consented to surgery have relatively severe pain or disability. These severities in pain or disabilities have no correlation with sex or level of disc herniation and are not equal with developed countries
ABSTRACT
Legg-Calve'-Perthes disease is a juvenile idiopathic osteonecrosis in which the blood supply of femoral head is not sufficient and the bone dies provisionally. The aim of this study is to evaluate outcome of Femoral osteotomy in children with LCPD in our University Hospital. In a descriptive analytic study, between 2008 and 2013, patients with the diagnosis of Legg-Calve'-Perthes confirmed with lateral pillar calcification of B and B/C border were entered and patients were encouraged to come to an outpatient clinic for follow-up. Descriptive analysis of the demographics was performed and relation between variables was tested using a two-sided Student's t test with statistical significance set at [p=0.05]. Mean age of patients was 9 +/- 1.3 years, with the range of 4 to 12 years old. 25 patients [86.2%] were male and 4 patients [13.4%] female. There was no positive family history in patients. 17 patients [58.6%] had history of trauma. Duration of symptom presentation was 7 +/- 6.3 months, with the range of 3 to 36 months. In 20 of patients [69%] left hip and in 12 [41.4%] right hip was involved. There was significant relation between femoral head asymmetry, trochanter enlargement [P=0.04], acetabolum changes [P<0.000], femoral neck shortening [P<0.000]. There was no relation between age [P=0.28] and duration of disease [P=0.8] with femoral neck shortening. Intrtrochantric Osteotomy led to improvement in pain, limping and increase range of motion. Subluxation before surgery is one of the criteria, which could influence further prognosis. Acetabulom changes and femoral neck shortening are two factor seriously effect hip ROM