Should Discectomy Performed Without Replacement be the First Choice in Patients with Pain and Reduced Mouth Opening?

Year 2020, Volume: 21 Issue: 2, 147 - 154, 31.08.2020

Burcu Gürsoytrak , Umut Demetoğlu

Abstract

Objective: In this study, we evaluated the pain and functional development of patients with internal derangements before and after discectomy.
Materials and Methods: This was a retrospective cohort study in which patients with internal derangement underwent discectomy without replacement. The main primary variables were pre- and post-operative maximum mouth opening (MMO) and pain according to the Visual Analogue scale (VAS). Paired t-test was used to compare means to determine the differences between pre- and post-operative mouth opening and pre- and post-operative VAS.
Results: Among the 20 patients included in this study, six and 14 underwent bilateral and unilateral discectomy without replacement, respectively. Paired sample t-test results revealed that there was a difference in MMO pre- and postoperatively, whereas the VAS scale showed no difference in terms of pain. According to the Wilkes classification, the difference between pre- and post-operative MMO of the patients was recorded. Based on these findings, no difference was observed between the mean pre- and post-operative MMOs of Wilkes stage III and IV patients, whereas a significant difference was found between Wilkes stage V and III patients (p<0.05). No significant difference was found between Wilkes stage IV and V patients (p>0.05).
Conclusion: In Wilkes stage III and IV subjects, discectomy without replacement is a good treatment option to relieve pain and improve functions in cases where conservative treatment fails.

Keywords

Temporomandibular joint , discectomy , internal derangement , Wilkes stage

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