Little information is at hand on the diagnostic values of the clinical symptoms and signs in the level diagnosis of patients with lower Lumbar disc herniation. We examined one hundred and thirty nine consecutive candidates for lower Lumbar discectomy. Monoradicular pain with sings attributed to the fifth Lumbar and first sacral root dysfunctions were evaluated independently in each patient. Intra-operatively, all patients were assessed by a single neurosurgeon for the level of disc herniation. We reached the conclusion that the diagnostic vale of clinical features of the herniated fifth Lumbar disc is higher than that of the fourth Lumbar disc herniation. The value of clinical presentation in the level diagnosis of lower Lumbar disc herniation is highly specific, but rather insensitive.

Introduction: The aims of this study was to estimate prevalence, Clinical finding and results of operation and long term outcome of lumber intervertebral disc herniation in children less than 15 years of age.Method of study and Results: Out of 1232 patients with Lumber disc herniation (L.D.H.) admitted Ghaem Hospital since 1985 to 1999.Ten children (8-15 years) underwent surgery for L.D.H. Six patients were female and four were male. The chief complaints were low back pain, lower limb pain, or both. The most common evolved intervertebral disc was L4-L5.The results of operation were favorable and the patients became symptom free. They were followed for 1-13 years, no recurrence was observed.Conclusion: The conservative treatment in H.L.D. in children is not satisfactory and surgery preferable.

Introduction: Surgical treatment of Lumbar disc herniation (LDH) is one of the most common surgeries in the world. In many studies the success is related to the radiological results. The aim of this study, however, is to determine the effects of some psychological factors such as depression, anxiety and patients’ expectations concerning their satisfaction from Disk herniation surgery (DHS).Materials and Methods: Sixty patients who were candidates for DHS were examined for depression, expectations, anxiety and satisfaction before and three months after the surgery using standard questionnaires.Results: The patients consisted of 33 females (55%) and 27 males (45%). The average of pain acuity before the surgery was measured as 7.25 units which decreased to 2.1 units after the operation. 93.3% of the subjects were diagnosed with anxiety of different degrees and 66.7% with depression. 70% had high expectations. The patients’ satisfaction rate was ranging from 1.7 to 8.9 (mean= 5.5).  Satisfaction gained the highest rate in the patients aging between 30-39 years old. Also, depression and high expectations were found to be associated with lower levels of satisfaction.Conclusion: Depression decreases patient’s satisfaction while low expectations can increase it.

This article reports the outcome of a series of patients who received surgical treatment for Lumbar disc herniation during a 5 year period in Kashani hospital. Three operative procedures were used for discectomy: unilateral interlaminar bilateral interlaminar and bilateral laminectomy. An objective method of assessing outcome that would not depend on the procedures, the prolo functional-economic outcome rating scale used to evaluate patients. Most patients had good outcome. The patient with non-industrial injuries had better had good outcome. The patient with non-industrial injuries had better outcome. The prolo scale appears to be a useful tool for comparing different procedures more objectively and for comparing the outcome across series.

A woman presenting with severe right lower quadrant (RLQ) abdominal pain is presented here. She was evaluated for all usual cause of such pain. Laboratory tests and abdominal and pelvic sonography was normal. MRI revealed L1-L2 disc herniation.

Background & Aim: Lumbosacral pain is extremely common as age increases. Spinal instrumentation is sometimes recommended for Lumbar canal stenosis and disk herniation surgery. This study aimed at studying the frequency of instrumentation in patients referring to our center.Methods & Materials/Patients: This retrospective cross-sectional study included 1200 patients with low back and/or radicular pain who had referred to the Shahid Beheshti and Ayatallah Roohani hospitals from 2013 to 2014 in Babol city. Data were analyzed by t-test and chisquare using SPSS (Version 20).Results: In this study, 150 of 1200 patients needed surgery for Lumbar canal stenosis and/or disk herniation (mean age of 42.21 ± 11.41 years old, ranging from 26-69). Of all patients, 76 were men (50.7%) and 74 women (49.3%). L4-L5 was the most involved level. There was a significant relationship between pathology and gender (p<001). At some levels, either men or women were involved. Moreover, 55 patients (36.7%) underwent surgery with instrumentation and 95 patients (63.3%) without instrumentation. Complete improvement was reported in 102 patients (68%). No significant relationship was observed between the degree of improvement and surgery technique and gender (p=0.78, p=0.72).Conclusion: Most patients (63.3%) underwent surgery without instrumentation and about one third needed fixation during surgery.

Background: Lumbar disc herniation is one of the most common causes of low back pain and after pulmonary disease, low back pain is the second most common reason to see a doctor. Diagnosis of Lumbar disc herniation in a patient presenting with sciatica is based on history, clinical signs, physical examination, and MRI or CT imaging techniques. Pain Most patients who present with sciatica due to Lumbar disc herniation respond to conservative and rest treatments, but patients who do not respond to medical treatment and rest undergo Lumbar MRI imaging without contrast and if indicated Clinically, the presence of a disc herniation undergoes surgery with a pressure effect on the spinal sac or nerve root. Clinical indication for Lumbar disc herniation surgery occurs when, despite rest, the pain persists for more than 4 weeks, due to high pressure, the person develops paresthesia in the lower extremities, the patient's pain recurs frequently and the patient's life Disrupt. Chronic diseases such as back pain have important consequences, including changes in people's quality of life. Quality of life is a multidimensional structure that is characterized by social, mental and physical vitality and causes a feeling of vitality and satisfaction with life, and certainly spinal surgery affects the quality of life in all dimensions. In the present study, the quality of patients' health before and after Lumbar disc herniation surgery and the necessity of disc surgery were investigated. Methods: In this descriptive-analytical study in which samples were selected by convenience, 90 patients with chronic low back pain who were candidates for Lumbar disc herniation surgery were studied. Data were collected through the 36-SF Health Quality Questionnaire and also using a demographic questionnaire, patient demographic information including age, sex, height, weight, smoking, occupation and level of education was collected. Before the operation, the 36-SF questionnaire was used to assess the quality of patients' health. After the operation, patients were followed up in two stages of 6 months and then 12 months with the help of the questionnaire and their quality of life was re-evaluated. Exclusion criteria included patients who had complications from surgery during the follow-up period, including wound infection, nerve root damage and neurological defects, incomplete recovery of lower back and lower extremity pain, and recurrence of disc herniation. They were Lumbar or found a new history of other diseases such as stroke, rheumatoid arthritis, autoimmune disease, in which case they were excluded from the study. Descriptive statistics including calculation of numerical indices (mean and standard deviation) for quantitative traits and percentage for qualitative traits were used for summarization. Also, paired t-test was used to analyze quantitative data and Wilcoxon test was used if necessary and KS test was used for data normality. The stratification method was used for comparative purposes in terms of contextual variables. Then the samples were analyzed with SPSS-20 software. Results: Mean and standard deviation of score improvement in physical dimension of quality of life before and 6 months after treatment in terms of sex were 38. 60 9 9. 13 in men and 31. 90 56 8. 56 in women, which was statistically different. Was significant (p = 0. 005). Also, the mean and standard deviation of the score improvement in physical dimension of quality of life before and 12 months after treatment was 43. 58 6 6. 72 in men and 40. 37 24 7. 24 in women, which was not statistically significant (p=0. 009). The mean and standard deviation of the score improvement in the psychological dimension of quality of life before and 6 months after treatment was 18. 41 ± 11. 72 in men and 14. 26 37 7. 37 in women, which was statistically significant (p<0. 001)), also the mean and standard deviation of the score improvement in the psychological dimension of quality of life before and 12 months after treatment was estimated to be 24. 93 9 9. 69 in men and 29. 26 86 8. 86 in women, which was statistically significant. In women, there was more improvement than men. Mean and standard deviation of score improvement in physical dimension Quality of life before and 6 months after treatment in patients based on the duration of low back and lower limb pain, in two groups under 2 months and above 2 months were studied. The results showed that in the group under 2 months, 39. 06 18 7. 18 in the group above 2 months was 32. 59 36 9. 36 which was statistically significant (p=0. 012) so that Patients with less back and lower limb pain (less than 2 months) showed more improvement. Also, the mean and standard deviation of the score improvement in the physical dimension of quality of life before and 12 months after treatment in the group under 2 months was 45. 37 86 7. 86 in the group over 2 months was 38. 68 10 10. 31, which was different from Statistically significant (p=0. 08) that patients with less back and lower extremity pain (less than 2 months) showed more improvement. In general, the mean score of physical and mental health improvement was significantly different from Paying attention to body mass index, number of involved discs and smoking before, 6 and 12 months later showed that according to the results of independent t-test, the score of improving the quality of life in physical and mental dimensions; Compared to before, 6 months and 12 months after surgery were statistically significant among men and women and showed an increase in quality of life in both physical and psychological dimensions (p<0. 001). Conclusion: The results of the present study showed that the quality of life in the present study in the time periods before treatment, 6 and 12 months after treatment caused a significant improvement in the physical and mental condition of patients with Lumbar disc herniation so that the mean score of quality of life Before the intervention, it was increased to 5. 94 29 29. 5, 6 months after the intervention to 60. 17 4 4. 55 and in 12 months after the intervention to 65. 26 6 6. 18, which statistical test also showed a significant increase (p<0. 001).

Background: The disability caused by the lower back pain is one of the leading factors contributing to work absenteeism. This disability which is usually due to spinal disc herniation prevents anemployee from doing his/her daily job, thus creating numerous destructive socioeconomic consequences for him/her as well as the society. The goal of this study is to determine the patients return-to-work rate after undergoing the Lumbar disc herniation surgery and to study the related factors.Methods: This study was a cross sectional study. All patients suffered from lumber discectomy from 2005 to 2009 at two TUMS (Tehran University of Medical Sciences) educational hospitals were included in this study. Required data about the patients were gathered from the hospital documents, and the return-to-work rate was evaluated by following up on patients via phone calls. Chi-square and T tests were used for evaluation of quantitative and qualitative variables, respectively.Results: From 603 final participants, at least 6 month after the surgery, 504 cases (83.6%) returned to work. From these 504 cases, 364 patients (72.2%) returned full time, and 140 patients (27.8%) returned part time. A multivariate regression analysis showed that the return-to-work rate has a strong correlation with age, sex, educational level, body mass index, positive expectation from the surgery before doing it, doctor's encouragement, hospitalization time, manual work, and job satisfaction (p<0.05), however, it had no significant correlation with marriage status, income level, impairment request, insurance coverage, peer support, and the work category with respect to physical labor demand (p>0.05).Conclusions: Our findings show the importance of work related and psychological factors as the determinants of the return-to-work rate after the Lumbar disc surgery. From this study, it is apparent that appropriate strategies and team work (between the patient, the surgeon, the rehabilitation specialist, the occupational medicine specialist, and the employer) would elevate the job satisfaction and positive expectations about the surgery, and therefore, they encourage the patient to return to work at a suitable time which in turn, may increase the total return-to-work rate.