A) Demographically:
Age:
A sample of 134 patients attending Al-Mujtahid Hospital was collected, and the average age in the sample was 50.56 (± 10.69), the youngest being 15 years and the eldest being 72 years.
Table 1
Distribution of the sample by Age
Age | |
Mean (standard deviation) | 50.65 (± 10.69) |
Oldest age | 15 |
Youngest age | 72 |
Place of Admitting :
60% of the sample were patients admitted to the specialized department, 4% of them were admitted to the ER.
Table 2
Distribution of the sample by place of admitting
place of admitting | |
in the department | 80 (60) |
in the clinic | 48 (36) |
in the Emergency room (ER) | 5 (4) |
Gender:
The vast majority of the sample were females, about 75%, while the percentage of males was 25%.
Table 3
Distribution of the sample by gender
Gender | |
Male | 33 (25) |
Female | 100 (75) |
Origins and Residence:
The largest percentage of patients were from Damascus countryside governorate, about 31% of the sample, followed by 26% of the sample from Damascus governorate.
Table 4
Distribution of the sample by governorate
Governorate | |
Al-Hasakah | 8 (6) |
Al-Raqqah | 11 (8) |
Suwayda | 3 (2) |
Qamishli | 5 (4) |
Latakia | 1 (1) |
Aleppo | 3 (2) |
Hama | 3 (2) |
Homs | 3 (2) |
Daraa | 17 (13) |
Damascus | 34 (26) |
Deer Al Zour | 4 (3) |
Damascus Countryside | 41 (31) |
Table 5
Distribution of the sample by Residence
Residence | |
countryside | 100 (75) |
city | 33 (25) |
Profession and work:
The vast majority of the sample are rural residents, at a rate of 75%. In terms of profession and work, almost all females recorded that they are housewives.
Table 6
Distribution of the sample by profession and work
Profession and work | |
housewife | 98 (73) |
driver | 1 (1) |
student | 1 (1) |
Did not mention | 33 (25) |
Family and medical history:
The vast majority of the sample, about 99%, confirmed that they had no family or genetic history, and only 11% confirmed that they had a history of hospital admission.
Table 7
Distribution of the sample by family and hereditary diseases
Family and hereditary diseases | |
None | 113 (99) |
Diabetes in Parents | 1 (1) |
Table 8
Distribution of the sample by history of hospitalization
Previous admission to a hospital | |
No | 106 (89) |
Yes | 13 (11) |
Smoking, Sheesha, Alcohol:
The vast majority of the sample confirmed that they are non-smokers, accounting for 87% of the sample, and 1% of the sample are alcoholics.
Table 9
Distribution of the sample by Habits
Smoking | |
Yes | 17 (13) |
No | 116 (87) |
Sheesha | |
Yes | 9 (7) |
No | 124 (93) |
Alcohol | |
Yes | 1 (1) |
No | 132 (99) |
B) Medical Aspect:
Duration of hospitalization and diagnosis:
The average duration of hospitalization was 12.36 months. Regarding the diagnosis, lumbosacral spondylolisthesis was diagnosed in the largest percentage of the sample, about 73% of the sample, and 13% had lumbar spondylolisthesis with herniation of the nucleus pulposus.
Table 10
Distribution of the sample by duration of hospitalization
hospitalization | (months) |
Mean (standard deviation) | 12.36 (± 7.22) |
Shortest period | 1 |
Longest period | 40 |
Table 11
Distribution of the sample by diagnosis
Diagnosis | |
Lumbar spondylolisthesis | 108 (78) |
First degree lumbar spondylolisthesis with isthmus degeneration OK | 1 (1) |
Lumbar spondylolisthesis with herniation of the nucleus pulposus | 15 (13) |
Lumbar spondylolisthesis with stenosis | 1 (1) |
Lumbar spondylolisthesis with herniation of the nucleus pulposus and stenosis | 5 (4) |
Lumbar spondylolisthesis with first lumbar fracture | 1 (1) |
Lumbar spondylolisthesis with collapse fracture | 1 (1) |
horse's tail | 1 (1) |
Pathology: |
Regarding the pathological mechanism, the largest percentage of the sample, 79%, did not know the pathological mechanism, while 10% had osteoporosis, and 8% had a lumbar spine injury.
Table 12
Distribution of the sample by pathological mechanism
Pathological mechanism | |
Brucellosis | 1 (1) |
Carrying weight | 2 (2) |
Trauma | 7 (8) |
Osteoporosis | 13 (10) |
Degenerative | 107 (79) |
Location of the injury and Health status: |
Regarding the location of the injury, 98% of the patients had a lumbar injury, and regarding the health condition, 49% confirmed that they suffered from pain, and 27% of the sample suffered from neurogenic claudication.
Table 13
Distribution of the sample by location of injury
Location of injury | |
Lumbar | 130 (98) |
Sacral | 1 (1) |
More than one location | 2 (1) |
Table 14
Distribution of the sample by health status
Health status | |
pain | 132 (49) |
Paresthesia | 3 (1) |
Muscle weakness and inability to walk | 34 (13) |
Muscle weakness that hinders daily life | 23 (9) |
Nervous claudication | 73 (27) |
Foot drop | 1 (1) |
Symptoms:
As for the symptoms that appeared, 36% suffered from pain, 21% suffered from numbness, 21% suffered from Paresthesia, and 19% suffered from muscle weakness.
Table 15
Distribution of the sample by symptoms
Symptoms | |
Urinary disorders | 5 (1) |
pain | 130 (36) |
Numbness | 78 (21) |
Paresthesia | 78 (21) |
Difficulty walking | 1 (1) |
Muscle weakness | 69 (19) |
Foot drop | 2 (1) |
Risk factors and Red Sings: |
In terms of risk factors, 10% have osteoporosis, 7% have Bruises on the spine. In addition to the basic red signs in the medical examination, 64% had lower muscle weakness, and 21% had constant numbness.
Table 16
Distribution of the sample by Risk factors
Risk factors | |
Brucellosis | 1 (1) |
Bruises on the spine | 9 (7) |
Osteoporosis | 13 (10) |
none | 110 (83) |
Table 17
Distribution of the sample by Red sings
Red sings | |
pain | 13 (8) |
Constant numbness | 34 (21) |
Lower muscle weakness | 101 (64) |
Manifestations of cauda equina syndrome | 7 (4) |
none | 2 (1) |
Health status after Discharge:
Upon discharge, 96% of the patients had no pain and symptoms improved with regular sphincter strengthening. Only 2% of the patients did not improve at all.
Table 18
Distribution of the sample by Health status after discharge
Health status after discharge | |
Lumbar pain at the surgical site, resolution of radicular pain, improvement of symptoms, and control of sphincters | 3 (2) |
The pain disappears with improvement in symptoms, normal strength, and controlled sphincters | 128 (96) |
The patient did not improve | 2 (2) |
C) Surgical Aspect:
Complications of the surgery:
Regarding the results of the surgical procedure, 94% of the patients underwent surgery without complications, 6% had complications, 3% of them had bleeding and blood transfusions, and regarding late complications, 95% had no complications.
Table 19
Distribution of the sample by surgical outcome
Surgical outcome | |
Successful surgery without complications | 125 (94) |
Complications occur | 8 (6) |
Table 20
Distribution of the sample by complications
Complications during and around surgery | |
Bleeding and blood transfusion | 4 (3) |
none | 129 (96) |
Late surgical complications | |
Wound infection and fixation device | 3 (3) |
Septic shock | 1 (1) |
The appearance of an abscess around the fixation device - drug renal failure | 1 (1) |
None | 127 (95) |
Materials used in surgery:
Regarding the materials used in surgery, 96% used screws and Rodini.
Table 21
Distribution of the sample by materials used in surgery
Materials used in surgery | |
Screws and Rodini | 134 (100) |
D) Laboratorial Aspect:
Before surgery:
Regarding the results of laboratory tests before surgery: 65% of patients had hemoglobin within normal, 69% had a normal count for red blood cells, while 14% had a decreased number of red blood cells, 74% had a normal number of white blood cells, and only 12% were higher than The normal limit, 80% have a normal platelet count, 46% have a PT higher than the normal limit, while only 5% have a PTT higher than the normal limit, and about 26% of the sample recorded an INR higher than the normal limit. In liver enzymes, 68% of the sample had normal Alt, 69% of the sample had normal AST, 90% of them had creatinine within the normal level, 89% of the sample had normal urea levels, 67% had normal blood sugar, while 24% had high blood sugar. Regarding electrolyte balance, 43% of the sample had normal calcium, 71% had normal potassium.
After Surgery:
After the surgical procedure, the normal tests were repeated and it was noted that 62% of the sample had a decrease in hemoglobin below the normal limit, 21% of the sample had a decrease in their red blood cell level below the normal limit, 27% of the sample had a rise in white blood cell level above the normal limit, 6% of the sample had a Platelets lower than normal, about 11% of the sample’s PT is higher than the normal limit, 5% of the sample had a PTT higher than the normal limit, with regard to the INR, 10% of the sample had a higher than normal rate, creatinine rose in 3%, urea rose above normal in 5% of the sample, and blood sugar rose in 10% of the sample after the surgical procedure. Regarding electrolyte balance, 22% of the sample remained within normal levels of calcium, 12% of the sample had a lower-than-normal level of potassium, and 3% of the sample had a decrease in their sodium level After surgery.
Table 22
Laboratory tests results before and after surgery
| Before surgery | After Surgery |
Hemoglobin | | |
Higher than the normal limit | 2 (2) | 1 (1) |
Lower than the normal limit | 33 (25) | 82 (62) |
Within the normal range | 87 (65) | 30 (23) |
Not mentioned | 11 (8) | 20 (15) |
Red blood cells | | |
Higher than the normal limit | 1 (1) | - |
Lower than the normal limit | 19 (14) | 1 (1) |
Within the normal range | 92 (69) | 82 (62) |
Not mentioned | 21 (16) | 30 (23) |
White blood cells | | |
Higher than the normal limit | 16 (12) | 36 (27) |
Lower than the normal limit | 9 (7) | 1 (1) |
Within the normal range | 98 (74) | 23 (17) |
Not mentioned | 10 (8) | 73 (55) |
Platelets | | |
Lower than the normal limit | 7 (6) | 8 (6) |
Within the normal range | 107 (80) | 46 (35) |
Not mentioned | 19 (14) | 79 (59) |
PT | | |
Higher than the normal limit | 61 (46) | 14 (11) |
Lower than the normal limit | 1 (1) | 1 (1) |
Within the normal range | 47 (35) | 15 (11) |
Not mentioned | 24 (18) | 103 (77) |
PTT | | |
Higher than the normal limit | 6 (5) | 6 (5) |
Lower than the normal limit | 2 (2) | - |
Within the normal range | 36 (27) | 12 (9) |
Not mentioned | 89 (67) | 115 (86) |
INR | | |
Higher than the normal limit | 35 (26) | 13 (10) |
Within the normal range | 72 (54) | 19 (14) |
Not mentioned | 26 (20) | 101 (76) |
ALT | | |
Higher than the normal limit | 4 (3) | 2 (2) |
Within the normal range | 91 (68) | 23 (17) |
Not mentioned | 38 (29) | 108 (81) |
AST | | |
Higher than the normal limit | 3 (2) | 2 (2) |
Within the normal range | 92 (69) | 23 (17) |
Not mentioned | 38 (29) | 108 (81) |
Creatinine | | |
Higher than the normal limit | 1 (1) | 4 (3) |
Lower than the normal limit | 1 (1) | 1 (1) |
Within the normal range | 120 (90) | 37 (28) |
Not mentioned | 11 (8) | 91 (68) |
Urea | | |
Higher than the normal limit | 4 (3) | 6 (5) |
Within the normal range | 118 (89) | 35 (26) |
Not mentioned | 11 (8) | 92 (69) |
Glucose | | |
Higher than the normal limit | 32 (24) | 13 (10) |
Lower than the normal limit | - | 1 (1) |
Within the normal range | 89 (67) | 32 (24) |
Not mentioned | 12 (9) | 87 (65) |
Calcium | | |
Higher than the normal limit | 1 (1) | - |
Within the normal range | 57 (43) | 29 (22) |
Not mentioned | 75 (56) | 104 (78) |
Potassium | | |
Higher than the normal limit | 8 (6) | 3 (3) |
Lower than the normal limit | 10 (8) | 16 (12) |
Within the normal range | 95 (71) | 39 (29) |
Not mentioned | 20 (15) | 75 (56) |
Sodium | | |
Higher than the normal limit | 2 (2) | - |
Lower than the normal limit | 8 (6) | 4 (3) |
Within the normal range | 102 (77) | 54 (41) |
Not mentioned | 21 (16) | 75 (56) |
E) Imaging:
The vast majority of the sample, about 94% of the sample, had an MRI performed, while only 8% had a CT scan, and 24% of the sample had a simple x-ray.
Table 23
Distribution of sample by doing radiographic investigations
Radiographic investigations | yes | no |
Axial CT scan | 11 (8) | 122 (92) |
MRI | 125 (94) | 8 (6) |
Simple X-ray | 32 (24) | 101 (76) |
F) Hospitalization:
Regarding hospital stay, only 2% (about 3 patients) of the sample needed to stay in ICU, one patient needed to stay for one day, and two patients needed to stay for two days, as they were carefully monitored within the sample, and the reason for entering the hospital was due to complications from the surgical procedure.
Table 24
Distribution of the sample by the need to stay at ICU
Is there a need to stay at ICU? | |
Yes | 3 (2) |
no | 130 (98) |
Table 25
Distribution of the sample by Duration of staying at ICU
Duration of staying at ICU | |
One day | 1 (1) |
Two days | 2 (2) |
Didn't stay at ICU | 130 (98) |
Table 26
Distribution of the sample by Actions taken in ICU
Actions taken in ICU | |
monitoring | 3 (2) |
Didn't stay at ICU | 130 (98) |
Table 27
Distribution of the sample by Reason for entering ICU
Reason for entering care | |
Due to complications of surgery | 3 (2) |
Didn't need to stay at ICU | 130 (98) |