Mhina, Robert Isaac2019-08-302020-01-082019-08-302020-01-081991Mhina, R. I (1991) Low back pain diagnosis and surgical treatment, Masters dissertation, University of Dar es Salaam. Available at (http://41.86.178.3/internetserver3.1.2/detail.aspx?parentpriref=)http://localhost:8080/xmlui/handle/123456789/6085Available in print formOBJECTIVES: To study the approach to the problem of Low Back Pain and the role of surgery in its treatment. METHODOLOGY: This was an 18 month prospective study of patients surgically treated for Low Back Pain at Dormagen Hospital (Kreiskrankenhaus Dormagen) West Germany. The first 12 months were devoted to data collection and active participation in patient management and the last 6 months to data analysis and follow-up. SUMMARY: Low Back Pain (LBP) is a serious problem both in magnitude and management. Between August 1988 and July 989 it accounted for 90.3 of the spinal surgery load of the Orthopaedic Department of Dormagen Hospital. Surgery of the spine was 9.2% of all the Orthopaedic surgical procedures. 109 patients were studied. The male to female ratio was 1:1 and the age ranged between 20 and 88 years with a mean of 49.5 years. The peak incidence was observed in the 4th, 5th and 6th decades of life. 65.1% had chronic Low Back Pain, 20.2% and 14.7% sub acute and acute respectively. Significant trauma was noted in 8.3% of the patients and serious obesity was observed in 8.3%. The Herniated intervertebral disc was the commonest cause of LBP followed by spinal canal stenosis, foraminal stenosis and neoplastic conditions. The spinal levels L4/L5 and L5/S1 were most frequently affected. Radiology was the most frequently used tool for diagnosis. Standard discectomy, hemilaminectomy, root decompression and combined discectomy and fusion were the common forms of surgery done. 67.9% of the patients benefitted from surgery while 12.8% did not. CONCLUSION: In carefully selected patients surgery has a significant role to play in the treatment of LBP. Psychological valuation of the patients is important. Prevention of LBP is a challenge in orthopaedics. The use of the back-school, improvement of work conditions and routine screening of the population are a step towards this goal.enSurgeryOperativeThesis