Long-Term Outcome of Patients who Underwent Percutaneous Nucleotomy for Lumbar Disc Herniation: Results after a Mean Follow-up of 5 Years

Lumbar disc herniation (LDH) is a common cause of back and sciatic pain. When clinical treatment fails, surgery may be indicated in selected patients. Although surgery is effective in most cases, some of these patients may have a poor outcome. Different factors may influence these results and poor adaptation at work is one well-known cause of treatment failure. This study examines 350 patients on long-term follow-up after surgery for first-time LDH. The relationship was analyzed between occupation before surgery and outcome (maintenance of lumbar and leg pain, satisfaction with the surgical treatment and return to work). The preoperative occupation (employed in public or private services, autonomous, unemployed, housewife, retired or student) and the exertion at work were analyzed as prognostic factors for different clinical outcomes. Although unemployed people had higher numerical analog scale for lumbar pain and retired patients had a higher leg pain, this difference was not statistically significant. Retired people were significantly less satisfied with the surgical result. Higher exertion at work showed a statistically insignificant higher level of pain and lower degree of satisfaction. The authors conclude that preoperative occupation was not a statistically significant factor in this series of patients.

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Long-Term Follow-Up Results of Day Surgery for Lumbar Disc Herniation Using Percutaneous Endoscopic Lumbar Discectomy: A Single-Center Experience of 267 Cases.

10.21203/rs.3.rs-109537/v1 ◽

2020 ◽

Author(s):

Zhaojun Song ◽

Maobo Ran ◽

Juan Luo ◽

Kai Zhang ◽

Yongjie Ye ◽

...

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Day Surgery ◽

Lumbar Discectomy ◽

Hospitalized Patients ◽

Disc Height ◽

Endoscopic Lumbar Discectomy

Abstract Background: Although numerous studies have shown good clinical results of percutaneous endoscopic lumbar discectomy (PELD) for hospitalized patients with lumbar disc herniation (LDH), there are few articles that report on the day surgery patients undergoing PELD.Methods: Atotal of 267 patients with LDH received PELD during day surgery were followed up for at least 3 years. Relevant data and clinical outcomeswere recorded and assessed. Meanwhile, we compared the clinical effects between patients treated by PELD during day surgery and microendoscopic discectomy (MED) for contemporaneous hospitalized patients with LDH (116 patients).Results: Patients treated by PELD had lower blood loss (10.8 ± 4.1 mL, 71.3 ± 23.3 mL,respectively; P < 0.001) and shorter hospital stay ( 22.7 ± 4.2 hours, 48.1 ± 22.6 hours, respectively; P < 0.001 ) compared with patients treated by MED. The visual analogue scale (VAS) for leg and back pain (VAS-L and VAS-B, respectively) and Oswestry disability index (ODI) decreased significantly after PELD than those before the operation at 3 years postoperative, and the postoperative VAS-B in PELD group was significantly decreased from the MED group ( P = 0.001). The complications rate was 9.4% (25/267) in the PELD group and 12.1% (14/116) in the MED group, without significant difference ( P = 0.471). The 1-year postoperative recurrence rate in PELD group ( 5.2%, 14/267) was much higher than that in MED group ( 0.9%, 1/116) ( P = 0.042). The postoperative lumbar lordosis（LL）(34.0 ±10.3 ), and sacral slope（SS) (27.5 ± 5.6) in PELD group improved significantly compared with the values in MED group (26.9 ± 9.8, 23.6 ± 6.8, respectively; all P < 0.001). The disc-height ratio at 3-year follow-up was ( 85.7 ± 6.4) % of the preoperative disc height in PELD group while ( 81.9 ± 7.0) % in MED group，with significant height loss in MED group ( P = 0.014).Conclusions: Day surgery for LDH undergoing PELD has favorable long-term outcomes.

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Minimum of Two-Year Follow-up After Percutaneous Endoscopic Transforaminal Discectomy on Lumbar Disc Herniation: Clinical and Radiographic Outcomes

10.21203/rs.3.rs-1050709/v1 ◽

2021 ◽

Author(s):

Lei Yue ◽

Hao Chen ◽

Guanzhang Mu ◽

Bingxu Li ◽

Haoyong Fu ◽

...

Keyword(s):

Factor Analysis ◽

Risk Factor ◽

Intervertebral Disc ◽

Clinical Outcomes ◽

Disc Degeneration ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc

Abstract Background Percutaneous endoscopic transforaminal discectomy (PETD) is a widely-used minimally invasive technique in treating lumbar disc herniation (LDH), our aim was to investigate the long-term effect of PETD on clinical outcomes and magnetic resonance imaging (MRI) characteristics of LDH patients.Methods This is a retrospective case series to assess patients who underwent single level PETD from January 2015 to June 2019 with a minimum follow-up of 2 years. Clinical outcomes included numeric rating scale (NRS), Oswestry Disability Index (ODI) and adverse events. Radiographic parameters included sagittal spine geometry, characteristics of protrusion, and degeneration grading of intervertebral disc and facet joint. Sensitivity analysis and risk factor analysis were also performed.Results Thirty-eight patients (43.16 ± 13.32 years; M: F = 20: 18) were assessed. During the follow-up period (33.47±12.53 months), the mean disc height decreased from 10.27 ± 1.92 mm to 8.95 ± 1.74 mm (P=0.000), and lumbar lordosis increased from 31.31 ± 8.63° to 35.07 ± 8.07° (P=0.002). The size of protrusion significantly decreased after PETD (P=0.000). Disc degeneration grading was generally higher at last follow-up compared with baseline (p=0.002). Compared with baseline, significant improvements were observed on NRS and ODI at 3-months follow-up and the last follow-up. On risk factor analysis, facet tropism was correlated with radiographic recurrence of disc herniation (OR=6.00 [95% confidential interval (CI)1.176-30.624], p=0.031).Conclusions This study demonstrates that at long-term follow-up, despite the good clinical results, the PETD resulted in significant aggravation of intervertebral disc degeneration.

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Long-term Follow-up Study of Radiographic Evaluation after Percutaneous Discectomy for Lumbar Disc Herniation.

Orthopedics & Traumatology ◽

10.5035/nishiseisai.47.1078 ◽

1998 ◽

Vol 47 (3) ◽

pp. 1078-1080

Author(s):

Sukeaki Kabayama ◽

Kazunori Yone ◽

Masao Yamaguchi ◽

Takashi Sakou

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Radiographic Evaluation ◽

Percutaneous Discectomy ◽

Follow Up Study ◽

Long Term Follow Up

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Outcome analysis of patients after ligament-sparing microdiscectomy for lumbar disc herniation

Neurosurgical FOCUS ◽

10.3171/foc.2002.13.2.5 ◽

2002 ◽

Vol 13 (2) ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Youn-Kwan Park ◽

Joo-Han Kim ◽

Heung-Seob Chung

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Successful Outcome ◽

Outcome Analysis ◽

Safe Procedure ◽

Repeated Surgery ◽

Independent Assessment

Object The authors describe a microsurgical technique for the preservation of the ligamentum flavum and the long-term surgery-related results, including an independent assessment of outcome. Methods Three hundred seventy-seven patients underwent ligament-sparing microsurgical discectomy for a previously untreated single-level lumbar disc herniation and were followed for more than 2 years. A successful outcome at 6 months was demonstrated in 93.9% of the patients. At a median follow-up period of 30 months, successful patient-assessed outcome was 84.1%. During the mean follow-up period of 4.2 years (range 2–6.5 years), recurrent disc herniation was detected in 18 patients (4.8%). These patients all underwent repeated surgery. The overall surgery-related rate of complications was 1.3%. Conclusions The authors conclude that ligament-sparing microdiscectomy is a safe procedure, with a favorable success rate and minimal morbidity. Reoperation is safer and easier when using this technique compared with traditional ones.

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Risk Factors and Post-Operative Predictors for Recurrent Lumbar Disc Herniation

Journal of Applied Health Sciences ◽

10.24141/1/7/2/2 ◽

2021 ◽

Vol 7 (2) ◽

pp. 121-126

Author(s):

Riccardo Paracino ◽

Fabrizio Mancini ◽

Simona Lattanzi ◽

Mauro Dobran

Keyword(s):

Risk Factors ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Disc Hernia ◽

Post Surgery ◽

Long Term Follow Up ◽

Lumbar Disc Hernia

The purpose of this study is to identify some risk factors and post-operative predictors for recurrent lumbar disc hernia (rLDH) during a long-term follow-up in patients treated with microdiscectomy. Aim of the paper: This study analyzes some risk factors and postoperative predictors for recurrent lumbar disc hernia (rLDH) during a long-term follow-up in patients treated with microdiscectomy. Material and methods. We analyzed retrospectively a consecutive series of patients who underwent lumbar spinal microdiscectomy for lumbar disc herniation (LDH) from January 2013 to June 2018 at our Institute. The rate of rLDH during long-term follow-up was analyzed and correlated with baseline and post-operative data. Results. A total of 263 patients were included with a median follow-up time of 24 months (from 13 to 43 months). Most of the patients had rLDH within the first 36 months after surgery. At multivariate analysis, recurrence of LDH was associated with higher pre-operative body mass index (BMI) and higher post-operative Oswentry disability index (ODI) with statistical significance. Conclusions. Baseline BMI and post-surgery ODI could predict rLDH after surgery during a long-term follow-up.

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Endoscopic lumbar discectomy using side viewing conical working tube

Romanian Neurosurgery ◽

10.33962/roneuro-2021-018 ◽

2021 ◽

pp. 108-113

Author(s):

Mohammad Kaif ◽

Kuldeep Yadav ◽

Rakesh Kumar ◽

Deepak Kumar Singh

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Long Term Results ◽

Lumbar Disc Prolapse ◽

Endoscopic Discectomy ◽

The Mean ◽

Endoscopic Lumbar Discectomy

Objective: The paradigm of surgical therapy for spinal disease especially for lumbar disc herniation has gradually shifted from traditional open surgeries to minimally invasive spinal surgeries. Endoscopic discectomy has been performed widely using various devices and techniques. In this study, we present our experience of endoscopic discectomy using a unique device with separate side viewing channel. Methods: 26 patients of lumbar disc herniation treated between March 2015 to April 2018 using the unique conical working tube with separate side-viewing endoscopic channel have been retrospectively analysed. Their preoperative and postoperative Oswestry Disability Index (ODI) and Macnab scores were used to evaluate the outcome with a mean follow up of 37.04 months. Results: There were 18 males and 08 females with age ranging from 19-72 years (mean-38.4 years). The follow up ranged from 25 months to 60 months with a mean of 37.04 months. The mean preoperative ODI score was 72.4 which decreased to a mean of 7.6 and the outcome evaluated by Macnab criteria was 65.3% excellent, 19.2 % good, 11.5% fair, 3.8% poor. 1 patient underwent a second surgery. None of the patients had to change their occupation postoperatively. Complications occurred were dural tear in 1 patient and transient foot paresis in 1 which improved spontaneously. Conclusion: Endoscopic discectomy using conical working tube is a safe and effective technique for lumbar disc prolapse. The long term results are comparable to conventional techniques.

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Lumbar disc herniation surgery in adolescents and young adults

The Bone & Joint Journal ◽

10.1302/0301-620x.101b12.bjj-2019-0621.r1 ◽

2019 ◽

Vol 101-B (12) ◽

pp. 1534-1541 ◽

Cited By ~ 1

Author(s):

Tobias Lagerbäck ◽

Hans Möller ◽

Paul Gerdhem

Keyword(s):

Young Adults ◽

Lumbar Spine ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Adolescents And Young Adults ◽

Lumbar Spine Surgery ◽

Patient Reported

AimsThe purpose of this study was to investigate the risk of additional surgery in the lumbar spine and to describe long-term changes in patient-reported outcomes after surgery for lumbar disc herniation in adolescents and young adults.Patients and MethodsWe conducted a retrospective study design on prospectively collected data from a national quality register. The 4537 patients were divided into two groups: adolescents (≤ 18 years old, n = 151) and young adults (19 to 39 years old, n = 4386). The risk of additional lumbar spine surgery was surveyed for a mean of 11.4 years (6.0 to 19.3) in all 4537 patients. Long-term patient-reported outcomes were available at a mean of 7.2 years (5.0 to 10.0) in up to 2716 patients and included satisfaction, global assessment for leg and back pain, Oswestry Disability Index, visual analogue scale for leg and back pain, EuroQol five-dimension questionnaire (EQ-5D), and 36-Item Short-Form Health Survey (SF-36) Mental Component Summary and Physical Component Summary scores. Statistical analyses were performed with Cox proportional hazard regression, chi-squared test, McNemar’s test, Welch–Satterthwaite t-test, and Wilcoxon’s signed-rank test.ResultsAny type of additional lumbar spine surgery was seen in 796 patients (18%). Surgery for lumbar disc herniation accounted for more than half of the additional surgeries. The risk of any additional surgery was 0.9 (95% confidence interval (CI) 0.6 to 1.4) and the risk of additional lumbar disc herniation surgery was 1.0 (0.6 to 1.7) in adolescents compared with the young adult group. Both age groups improved their patient-reported outcome data after surgery (all p < 0.001). Changes between short- (mean 1.9 years (1.0 to 2.0)) and long-term follow-up (mean 7.2 years (5.0 to 10.0)) were small.ConclusionThe risk of any additional lumbar spine surgery and additional lumbar disc herniation surgery was similar in adolescents and young adults. All patient-reported outcomes improved from preoperative to the short-term follow-up, while no likely clinically important differences between the short- and long-term follow-up were seen within both groups. Cite this article: Bone Joint J 2019;101-B:1534–1541

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