Treatment of lumbar disc herniation with radiculopathy. Clinical practice guidelines endorsed by The Polish Society of Spinal Surgery

2016 ◽  
Vol 50 (2) ◽  
pp. 101-108 ◽  
Author(s):  
Dariusz Latka ◽  
Grzegorz Miekisiak ◽  
Pawel Jarmuzek ◽  
Marcin Lachowski ◽  
Jacek Kaczmarczyk
Keyword(s):  
Clinical Practice ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Spinal Surgery ◽  
Lumbar Disc ◽  
Polish Society

scholarly journals Microendoscopic Spinal Surgery for Extremely Migrated Lumbar Disc Herniation with Bi-radicular lesion: A Report of Two Cases

2008 ◽  
Vol 57 (2) ◽  
pp. 221-224
Author(s):  
Kanehiro Matsuyama ◽  
Fumito Tanabe ◽  
Eiji Taketomi ◽  
Yasuhiro Ishidou ◽  
Takuya Yamamoto ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Spinal Surgery ◽  
Lumbar Disc

scholarly journals Does the microendoscopic technique reduce mortality and major complications in patients undergoing lumbar discectomy? A propensity score–matched analysis using a nationwide administrative database

2016 ◽  
Vol 40 (2) ◽  
pp. E5 ◽  
Author(s):  
Junichi Ohya ◽  
Yasushi Oshima ◽  
Hirotaka Chikuda ◽  
Takeshi Oichi ◽  
Hiroki Matsui ◽  
...  
Keyword(s):  
Propensity Score ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Spinal Surgery ◽  
Lumbar Disc ◽  
Lumbar Discectomy ◽  
Volume Number ◽  
Minimally Invasive Spinal Surgery ◽  
Major Complications ◽  
Significant Difference

OBJECTIVE Although minimally invasive spinal surgery has recently gained popularity, few nationwide studies have compared the adverse events that occur during endoscopic versus open spinal surgery. The purpose of this study was to compare perioperative complications associated with microendoscopic discectomy (MED) and open discectomy for patients with lumbar disc herniation. METHODS The authors retrospectively extracted from the Diagnosis Procedure Combination database, a national inpatient database in Japan, data for patients admitted between July 2010 and March 2013. Patients who underwent lumbar discectomy without fusion surgery were included in the analysis, and those with an urgent admission were excluded. The authors examined patient age, sex, Charlson Comorbidity Index, body mass index, smoking status, blood transfusion, duration of anesthesia, type of hospital, and hospital volume (number of patients undergoing discectomy at each hospital). One-to-one propensity score matching between the MED and open discectomy groups was performed to compare the proportions of in-hospital deaths, surgical site infections (SSIs), and major complications, including stroke, acute coronary events, pulmonary embolism, respiratory complications, urinary tract infection, and sepsis. The authors also compared the hospital length of stay between the 2 groups. RESULTS A total of 26,612 patients were identified in the database. The mean age was 49.6 years (SD 17.7 years). Among all patients, 17,406 (65.4%) were male and 6422 (24.1%) underwent MED. A propensity score–matched analysis with 6040 pairs of patients showed significant decreases in the occurrence of major complications (0.8% vs 1.3%, p = 0.01) and SSI (0.1% vs 0.2%, p = 0.02) in patients treated with MED compared with those who underwent open discectomy. Overall, MED was associated with significantly lower risks of major complications (OR 0.62, 95% CI 0.43–0.89, p = 0.01) and SSI (OR 0.29, 95% CI 0.09–0.87, p = 0.03) than open discectomy. There was a significant difference in length of hospital stay (11 vs 15 days, p < 0.001) between the groups. There was no significant difference in in-hospital mortality between MED and open discectomy. CONCLUSIONS The microendoscopic technique was associated with lower risks for SSI and major complications following discectomy in patients with lumbar disc herniation.

scholarly journals The diagnostic pitfalls of lumbar disc herniation---- malignant sciatic nerve tumour: two case reports and literature review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Li Zhao ◽  
Junqiang Wei ◽  
Chenguang Wan ◽  
Shuhong Han ◽  
He Sun
Keyword(s):  
Clinical Practice ◽  
Sciatic Nerve ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lower Limb ◽  
Lumbar Disc ◽  
Clinical Manifestations ◽  
B Cell Lymphoma ◽  
Malignant Tumours ◽  
The Right

Abstract Background Sciatica pain is a typical symptom of lumbar disc herniation (LDH), but some neurogenic and malignant tumours surrounding the sciatic nerve can also cause similar symptoms. These tumours are often misdiagnosed or even mistreated as LDH in clinical practice. Case presentation In our clinical practice, we found two patients with malignant tumours who were misdiagnosed with LDH. One patient complained of pain and numbness in the right lower limb. The primary diagnosis was LDH, and the patient underwent posterior lumbar interbody fusion surgery. After the operation, the symptoms were not alleviated. Then, diffuse large B-cell lymphoma involving the soft tissue and the sciatic nerve was identified. Another patient who manifested with radiating pain in the right lower limb was diagnosed with LDH at Chengde Central Hospital. He received regular conservative treatment for approximately 6 months, but his symptoms were not relieved, and then he was referred to our hospital. A malignant peripheral nerve sheath tumour (MPNST) of the sciatic nerve was diagnosed, and he received cisplatin (DDP) chemohyperthermia. Conclusions Descriptions of tumour lesions involving the sciatic nerve and misdiagnosed as LDH in the literature are rare. In the reported literature, 7 patients were misdiagnosed with LDH, and all patients presented with sciatica. Among them, 4 patients only received surgical treatment, 1 patient only underwent neurolysis, and 2 patients received both surgical and chemotherapy treatment. Their low incidence and similar clinical manifestations to LDH make malignant tumours involving the sciatic nerve easy to misdiagnose. When the clinical symptoms and signs are inconsistent with the imaging findings, we need to be aware of non-discogenic sciatica, including tumours involving the sciatic nerve. Furthermore, tumours that grow near the exit of the sciatic notch may be misdiagnosed because of their deeper location and because they are covered with gluteal muscles. Sometimes sciatica caused by sciatic nerve tumours is only distal, without any radicular distribution. This pain is more severe than that caused by LDH, and this pain is not related to the position of the lumbar spine. Thus, it is beneficial to perform a detailed physical examination of the sciatic nerve to avoid this kind of misdiagnosis.

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