Soft extraforaminal lumbar disc herniation: a comparison of 3 different surgical techniques

2009 ◽  
Vol 72 (5) ◽  
pp. 522
Author(s):  
G. Lesage ◽  
G. Dua ◽  
G. Beute ◽  
J. D'Haens
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Surgical Techniques

Recurrence Rate of Lumbar Disc Herniation After Standard Discectomy and Microdiscectomy: A 5-Year Study

2019 ◽  
Vol 12 (2) ◽  
pp. 139-146
Author(s):  
Mladen E. Ovcharov ◽  
Iliya V. Valkov ◽  
Milan N. Mladenovski ◽  
Nikolay V. Vasilev
Keyword(s):  
Recurrence Rate ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Surgical Techniques ◽  
Reoperation Rate ◽  
University Hospital ◽  
Recurrence Rates ◽  
Chi Square ◽  
Common Procedure

Summary Lumbar disc herniation (LDH) is the most common pathology in young people, as well as people of active age. Despite sophisticated and new minimally invasive surgical techniques and approaches, reoperations for recurrent lumbar disc herniation (rLDH) could not be avoided. LDH recurrence rates, reported in different studies, range from 5 to 25%. The purpose of this study was to estimate the recurrence rates of LDH after standard discectomy (SD) and microdiscectomy (MD), and compare them to those reported in the literature. Retrospectively, operative reports for the period 2012-2017 were reviewed on LDH surgeries performed at the Neurosurgery Clinic of Dr Georgi Stranski University Hospital in Pleven. Five hundred eighty-nine single-level lumbar discectomies were performed by one neurosurgeon. The diagnoses of recurrent disc herniation were based on the development of new symptoms and magnetic resonance/computed tomography (MRI/CT) images showing compatible lesions in the same lumbar level as the primary lumbar discectomies. The recurrence rate was determined by using chi-square tests and directional measures. SD was the most common procedure (498 patients) followed by MD (91 patients). The cumulative reoperation rate for rLDH was 7.5%. From a total number of reoperations, 26 were males (59.1%) and 18 were females (40.9%). Reoperation rates were 7.6% and 6.6% after SD and MD respectively. The recurrence rate was not significantly higher for SD. Our recurrence rate was 7.5%, which makes it comparable with the rates of 5-25% reported in the literature.

scholarly journals A Transforaminal Endoscopic Surgical Technique for Treating Lumbar Disc Herniation in the Setting of Spina Bifida

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Albert E. Telfeian ◽  
Adetokunbo Oyelese ◽  
Jared Fridley ◽  
Rohaid Ali ◽  
Deus Cielo ◽  
...  
Keyword(s):  
Spina Bifida ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Recent Literature ◽  
Lumbar Disc ◽  
Surgical Techniques ◽  
Surgical Decompression ◽  
Minimally Invasive Approach ◽  
Disc Disease ◽  
Invasive Approach

Recent literature suggests that adult patients with spina bifida receive surgery for degenerative disc disease at higher rates than the general population. However, sometimes the complex anatomic features of co-occurring spina bifida and lumbar disc herniation can significantly challenge standard surgical techniques. Here, the technical steps are presented for treating a foraminal lumbar 4-5-disc herniation in the setting of a patient with multifaceted degenerative and spina bifida occulta anatomy. Utilized is a minimally invasive approach that does not require general anesthesia or fusion and allows the patient to leave the same day. To the best of our knowledge, this is the first-reported case of endoscopic surgical decompression of a lumbar disc in a patient with spina bifida.

scholarly journals LUMBAR ENDOSCOPIC PERCUTANEOUS DISCECTOMY - CLINICAL OUTCOME. PROSPECTIVE STUDY

2017 ◽  
Vol 16 (3) ◽  
pp. 177-179 ◽  
Author(s):  
ANDRÉ LUÍS SEBBEN ◽  
XAVIER SOLER I GRAELLS ◽  
MARCEL LUIZ BENATO ◽  
PEDRO GREIN DEL SANTORO ◽  
ÁLYNSON LAROCCA KULCHESKI
Keyword(s):  
Surgical Treatment ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Gold Standard ◽  
Lumbar Disc ◽  
Surgical Techniques ◽  
Preoperative Period ◽  
Percutaneous Discectomy ◽  
Common Indication ◽  
Endoscopic Techniques

ABSTRACT Objective: Lumbar disc herniation is a common indication for surgical treatment of the spine. Open microdiscectomy is the gold standard. New surgical techniques have emerged, such as spinal endoscopy. We compared and evaluated two endoscopic techniques: the transforaminal and the interlaminar. Methods: Fifty-five patients underwent endoscopic technique and were assessed by VAS and ODI in the preoperative period, and in the first and sixth month after the procedure. Results: We had 89.1% of good results and 10.9% of complications. Conclusion: We conclude that endoscopic techniques are safe and effective for the surgical treatment of lumbar disc herniation.

Patient preferences for treatment of lumbar disc herniation: a discrete choice experiment

2021 ◽  
pp. 1-9
Author(s):  
Pravesh S. Gadjradj ◽  
Nicholas V. R. Smeele ◽  
Mandy de Jong ◽  
Paul R. A. M. Depauw ◽  
Maurits W. van Tulder ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Patient Preferences ◽  
Lumbar Disc ◽  
Recovery Period ◽  
Surgical Techniques ◽  
Lumbar Discectomy ◽  
Leg Pain ◽  
Out Of Pocket Costs

OBJECTIVE Lumbar discectomy is a frequently performed procedure to treat sciatica caused by lumbar disc herniation. Multiple surgical techniques are available, and the popularity of minimally invasive surgical techniques is increasing worldwide. Clinical outcomes between these techniques may not show any substantial differences. As lumbar discectomy is an elective procedure, patients’ own preferences play an important role in determining the procedure they will undergo. The aims of the current study were to determine the relative preference weights patients apply to various attributes of lumbar discectomy, determine if patient preferences change after surgery, identify preference heterogeneity for choosing surgery for sciatica, and calculate patient willingness to pay for other attributes. METHODS A discrete choice experiment (DCE) was conducted among patients with sciatica caused by lumbar disc herniation. A questionnaire was administered to patients before they underwent surgery and to an independent sample of patients who had already undergone surgery. The DCE required patients to choose between two surgical techniques or to opt out from 12 choice sets with alternating characteristic levels: waiting time for surgery, out-of-pocket costs, size of the scar, need of general anesthesia, need for hospitalization, effect on leg pain, and duration of the recovery period. RESULTS A total of 287 patients were included in the DCE analysis. All attributes, except scar size, had a significant influence on the overall preferences of patients. The effect on leg pain was the most important characteristic in the decision for a surgical procedure (by 44.8%). The potential out-of-pocket costs for the procedure (28.8%), the wait time (12.8%), need for general anesthesia (7.5%), need for hospitalization (4.3%), and the recovery period (1.8%) followed. Preferences were independent of the scores on patient-reported outcome measures and baseline characteristics. Three latent classes could be identified with specific preference patterns. Willingness-to-pay was the highest for effectiveness on leg pain, with patients willing to pay €3133 for a treatment that has a 90% effectiveness instead of 70%. CONCLUSIONS Effect on leg pain is the most important factor for patients in deciding to undergo surgery for sciatica. Not all proposed advantages of minimally invasive spine surgery (e.g., size of the scar, no need of general anesthesia) are necessarily perceived as advantages by patients. Spine surgeons should propose surgical techniques for sciatica, not only based on own ability and proposed eligibility, but also based on patient preferences as is part of shared decision making.

scholarly journals Percutaneous Endoscopic Spine Surgery for Extruded Lumbar Disc Herniation

2018 ◽  
Vol 12 (1) ◽  
pp. 482-495
Author(s):  
Mutombo Menga Arsene ◽  
Xiao-Tao Wu ◽  
Zan- Li Jiang ◽  
Lei Zhu
Keyword(s):  
Minimally Invasive ◽  
Lumbar Disc Herniation ◽  
Spine Surgery ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Surgical Techniques ◽  
Surgical Instruments ◽  
Disc Space ◽  
Advanced Technique ◽  
Endoscopic Spine Surgery

The conventional open discectomy is the gold standard for treating extruded lumbar disc herniation, especially in highly migrated lumbar disc herniation. Endoscopic spine surgery is known to be very challenging and technically demanding, in particular for highly migrated disc herniation. However, several studies have reported numerous effective techniques with results approximatively equal to conventional open surgeries or mini-open surgery. In the last few years, an increased number of endoscopic spine surgical techniques have been proposed in order to overcome various issues encountered in traditional endoscopic spine surgery. Nevertheless, surgical approach selection for treating extruded lumbar disc herniation is based on aspects such as anatomical structures, availability of surgical instruments, surgeon’s experience, and the disc herniation location. Advances in endoscopic visualization and instrumentation, as well as an increased demand for minimally invasive procedures, have led to the popularity of Percutaneous Endoscopic Lumbar Discectomy (PELD). PELD is a recent and advanced technique among other minimally invasive spine surgeries (MIS). It includes various kinds of surgical techniques to treat lumbar disc herniation and aims to offer a safe, less invasive surgical procedure for lumbar disc space decompression and removal of nucleus pulposus.

Clinical Outcomes After Standard Discectomy and Microdiscectomy for Lumbar Disc Herniation: A Single-Center Study

2020 ◽  
Vol 13 (1) ◽  
pp. 41-47
Author(s):  
Mladen E. Ovcharov
Keyword(s):  
Surgical Treatment ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Surgical Techniques ◽  
Postoperative Outcome ◽  
Clinical Results ◽  
Leg Pain ◽  
Clinical Aspects ◽  
Duration Of Symptoms

Summary Unsatisfactory results from lumbar disc herniation (LDH) conservative treatment suggest referral of patients for neurosurgical treatment. The time required for such a decision is considered to be about 4-6 weeks. In most cases, surgery quickly relieves pain symptoms, all along with the restoration of patient functions. The optimal surgical technique for LDH is theoretically controversial. We consider two discectomy methods as quite effective in our clinic: standard open discectomy (SD) and microdiscectomy (MD). Many retrospective studies have demonstrated the superiority of one of these techniques. Most studies describe microdiscectomy as a golden standard for surgical treatment of symptomatic disc herniation. We focused on the clinical aspects and correlations in the surgical treatment of LDH, as presented in the literature. The patients we present were divided by type of surgical procedure (SD or MD), and other parameters: sex, age, duration of symptoms, blood loss, duration of the operation, reoperation rate, Visual Analogue Scale (VAS), and Oswestry Disability Index (ODI). We used chi-square tests (ANOVA analysis) and directional measures to determine statistically significant data. Five hundred eighty-nine single-level lumbar discectomies were performed for five years (2012-2017), and all the patients presented with classical signs of the condition, i.e., vertebral and radicular syndromes. SD was performed on 498 patients, and MD – on 91 patients. Analyses of the parameters mean VAS values of lumbar and leg pain postoperatively, and within one month after surgery demonstrated statistically significant differences between standard and microdiscectomy (p<0.05). LDH surgical techniques have become more and more sophisticated over the last 40 years, but without substantial improvement in the functional and clinical results. Appropriate patient selection is a crucial factor for the postoperative outcome. Neurosurgeons should fully master the chosen technique for satisfactory postoperative results.

scholarly journals The Early Clinical Outcomes of a Percutaneous Full-Endoscopic Interlaminar Approach via a Surrounding Nerve Root Discectomy Operative Route for the Treatment of Ventral-Type Lumbar Disc Herniation

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Chao Shi ◽  
Weijun Kong ◽  
Wenbo Liao ◽  
Yanxiao Lu ◽  
Yao Fu ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Nerve Root ◽  
Clinical Symptoms ◽  
Lumbar Disc ◽  
Surgical Techniques ◽  
Operation Time ◽  
Effective Treatment Option ◽  
Nerve Root Injury ◽  
Interlaminar Approach

The objective of this study is to introduce a method using a percutaneous full-endoscopic interlaminar approach via a surrounding nerve root discectomy (SNRD) operative route that involves removing the protrusive disc via both the shoulder and the axilla of the corresponding nerve root for the treatment of ventral-type lumbar disc herniation (VLDH) and its early clinical symptoms. Twenty-two patients with VLDH satisfied the inclusion criteria and underwent the full-endoscopic interlaminar approach operation via a SNRD successfully during the period from November 2014 to June 2016. All operations were completed without conversion to other surgical techniques. The average operation time was 78.64 ± 25.97 min (50–145 min). The average removed disc tissue volume was 2.87 ± 0.48 ml (2–3.6 ml). No nerve root injury, infection, or other complications occurred. The postoperative ODI and VAS values of low back and sciatic pain were significantly decreased at each time point compared to preoperative measurements P<0.05. The MacNab scores at the 12-month follow-up included 15 excellent and 7 good scores. In summary, a percutaneous full-endoscopic interlaminar approach through SNRD is a safe and effective treatment option for patients with VLDH.

Sign in / Sign up

Export Citation Format

Share Document