Pre-operative Disc Volume Measurement as a Predictor for Sufficient Intra-operative Excision in Lumbar Open Fenestration Discectomies

Background and objectives: A study was implemented by assessing pre-operative disc volume and compare it to resected disc volume intra-operatively to minimize complications. The purpose of this study is to determine whether preoperative measurement of disc volume by magnetic resonance imaging could estimate the amount of disc need to be removed intraoperatively. Methods: This prospective cross-sectional study was conducted between 2021 and 2023, in which 44 patients were involved, the volume of the herniated disc. The height, width, and length of prolapsed disc were multiplied together and by 0.523, measured on magnetic resonance imaging machine, intraoperatively the resected disc was placed in the sterile syringe for measurement. Results: Out of 44 patients, 23 of them were males, and 21 were females. The mean age was 41.4 years. The most common level of involvement was the L4-L5 levels. The size of the herniated disc preoperatively ranged from 0.70 cc to 3.70, among them 72.7% of patients had a measurement between 1.0 cc and 2.0. Intraoperatively, the size of resected disc ranged from 1.0 cc to 4.2, 63.6% of them had volume exceeding 2.0 cc. Our data showed that neither the volume of the herniated disc nor the volume of the resected disc has any correlation to the age, gender and the level of disc involved. Conclusion: Preoperative measurement of lumbar disc herniation with a magnetic resonance image do not predict the disc volume that needs to be removed during surgery.