scholarly journals Enhanced Recovery after Surgery Protocol Accelerates Recovery of Lumbar Disc Herniation among Elderly Patients Undergoing Discectomy via Promoting Gastrointestinal Function

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Xiaohai Zuo ◽  
Linbang Wang ◽  
Longzhu He ◽  
Pei Li ◽  
Dandan Zhou ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Recovery Time ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Lumbar Disc ◽  
Length Of Hospital Stay ◽  
Feeding Time ◽  
Gastrointestinal Function ◽  
The Difference

This study aimed to analyze the effect of the enhanced recovery after surgery (ERAS) protocol on the recovery of gastrointestinal function in patients with lumbar disc herniation after discectomy. A total of 179 patients with lumbar disc herniation were randomly divided into the ERAS and non-ERAS groups. The non-ERAS group received routine nursing, and the ERAS group received ERAS strategy. The two groups were compared for general recovery indicators such as postoperative hemoglobin and prealbumin, satisfaction, and length of hospital stay. Gastrointestinal function was also evaluated, such as postoperative feeding time, intestinal chirping recovery time, intestinal exhaust gas recovery time, and complications such as ileus, nausea, and vomiting. The satisfaction of patients in the ERAS group (86.15 ± 2.43) was significantly higher than that in the non-ERAS group (77.19 ± 3.32), and the difference was statistically significant ( P < 0.05 ). The average time of eating in the ERAS group was 2.27 h after surgery. In addition, the amount of eating in the ERAS group was significantly better than that in the non-ERAS group, and the difference was statistically significant. In the ERAS group, intestinal chirping recovery time recovered to normal time, and exhaust recovery time and average defecation time were significantly shorter than those in the non-ERAS group. In the ERAS group, the average amount of hemoglobin and prealbumin decreased 3 days after operation, which was significantly lower than that in the non-ERAS group. To sum up, ERAS has an evident effect on the recovery of gastrointestinal function after discectomy of disc herniation, which can promote the recovery of patients.

scholarly journals Enhanced recovery after surgery pathway reduces the length of hospital stay without additional complications in lumbar disc herniation treated by percutaneous endoscopic transforaminal discectomy

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Wang Duojun ◽  
Zhang Hui ◽  
Lin Zaijun ◽  
Ge Yuxiang ◽  
Chen Haihong
Keyword(s):  
Hospital Stay ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Lumbar Disc ◽  
Length Of Hospital Stay ◽  
Single Level ◽  
Single Segment ◽  
Significant Difference

Abstract Background Enhanced recovery after surgery (ERAS) pathway in spine surgery is increasingly popular which can reduce the length of hospital stay (LOS). However, there are few studies on the safety and effectiveness of ERAS pathway in the treatment of single-level lumbar disc herniation (LDH) by percutaneous endoscopic transforaminal discectomy (PETD). The aim of this study was to investigate whether ERAS can reduce LOS of patients with single segment LDH treated by PETD. Methods We reviewed the outcomes of all LDH patients (L4/5) who had been treated with PETD at our institution. Quasi-experimental study was adopted between patients treated in an ERAS after PETD with those rehabilitated on a traditional pathway. The two groups were analyzed for LOS, operation time, complications, visual analog scale (VAS), Oswestry Dysfunction Index (ODI), hospitalization expenses (HE), and improved MacNab efficacy assessment criteria (MacNab). Results A total of 120 single segment LDH patients (ERAS pathway 60 cases, traditional care pathway 60 cases) who were selected from January 2019 to January 2021 met the inclusion criteria. There was a significant difference in mean LOS postoperative VAS scores and ODI on the 3rd day after surgery between the two groups (P < 0.05). The incidence of complications and HE were similar in the two groups (P > 0.05). The mean LOS decreased from 3.47 ± 1.14 days to 5.65 ± 1.39 days after application of ERAS pathway (P < 0.05). Conclusions The ERAS pathway reduced LOS without resulting in additional complications after PETD. These findings support the application of the perioperative ERAS pathway in the treatment of single-level LDH with PETD. Level of evidence Level IV, therapeutic

scholarly journals Open discectomy vs microdiscectomy for lumbar disc herniation - a protocol for a pragmatic comparative effectiveness study

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 2170 ◽  
Author(s):  
Andreas Sørlie ◽  
Sasha Gulati ◽  
Charalampis Giannadakis ◽  
Sven M. Carlsen ◽  
Øyvind Salvesen ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Relative Effectiveness ◽  
Length Of Hospital Stay ◽  
Postoperative Outcome ◽  
Leg Pain ◽  
Secondary Outcome ◽  
Clinical Registry

Introduction:  Since the introduction of lumbar microdiscectomy in the 1970’s, many studies have attempted to compare the effectiveness of this method with that of standard open discectomy with conflicting results. This observational study is designed to compare the relative effectiveness of microdiscectomy (MD) with open discectomy (OD) for treating lumbar disc herniation, -within a large cohort, recruited from daily clinical practice. Methods and analysis:   This study will include patients registered in the Norwegian Registry for Spine Surgery (NORspine). This clinical registry collects prospective data, including preoperative and postoperative outcome measures as well as individual and demographic parameters. The primary outcome is change in Oswestry disability index between baseline and 12 months after surgery. Secondary outcome measures are improvement of leg pain and changes in health related quality of life measured by the Euro-Qol-5D between baseline and 12 months after surgery, complications to surgery, duration of surgical procedures and length of hospital stay.

scholarly journals A novel vertebral trench technique (VTT) involving transforaminal endoscopic lumbar foraminotomy (TELF) for very highly up-migrated lumbar disc herniation above L5

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yong Yu ◽  
Ye Jiang ◽  
Fuling Xu ◽  
Yuhang Mao ◽  
Lutao Yuan ◽  
...  
Keyword(s):  
Nucleus Pulposus ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Japanese Orthopaedic Association ◽  
Length Of Hospital Stay ◽  
Visual Analogue Score ◽  
Radiologic Findings ◽  
Before And After ◽  
Endoscopic Lumbar Discectomy

Abstract Background Percutaneous endoscopic lumbar discectomy (PELD) has become popular for the treatment of symptomatic lumbar disc herniation (LDH). The very highly up-migrated lumbar disc herniation (VHUM-LDH) is difficult to remove under PELD. The purpose of this research is to investigate the feasibility, clinical efficacy and operative nuances of a novel VTT involving TELF for this type of herniation. Methods Eleven patients with very highly up-migrated LDH who underwent VTT involving TELF discectomy from May 2016 to May 2019 were included in this study. The operative time, length of hospital stay, and postoperative complications were recorded. Pre-and postoperative radiologic findings were investigated. All the patients were followed more than 1 year. The visual analogue score (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) scores and modified MacNab criteria were used to assess surgical efficacy. Results All the 11 patients underwent successful surgery. We compared the VAS, ODI, and JOA scores before and after surgery. The differences were statistically significant (P < 0.05). According to the modified MacNab criteria, 10 patients were assessed as “excellent”, 1 patient was assessed as “good” at the last follow up. Conclusion The novel VTT involving TELF discectomy is a supplement to the traditional PELD. This technique enables the endoscope with working cannula to get closer the sequestrated nucleus pulposus without irritating the exiting nerve root, and facilitates the nucleus pulposus be removed successfully under direct visualization. The VTT involving TELF discectomy can be a safe, effective and feasible surgical procedure for the treatment of LDH with very highly up-migrated.

scholarly journals Comparison of Endoscopic Discectomy Versus Non-Endoscopic Discectomy for Symptomatic Lumbar Disc Herniation: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 219256822110206
Author(s):  
Wei-Shang Li ◽  
Qi Yan ◽  
Lin Cong
Keyword(s):  
Systematic Review ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Complication Rate ◽  
Controlled Trial ◽  
Lumbar Disc ◽  
Length Of Hospital Stay ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Endoscopic Discectomy

Study Design: Systematic review. Objective: The authors aimed to systematically compare the effectiveness and safety of endoscopic discectomy (ED) with non-endoscopic discectomy (NED) for treatment of symptomatic lumbar disc herniation (LDH). Methods: A systematic search was performed on PubMed, EMBASE, the Cochrane Library and China National Knowledge Infrastructure for randomized controlled trial from inception until August 13, 2020. Trials which investigated multiple operative approaches on lumbar disc herniation were identified without language restrictions. Results: In total, 25 trials involving 2258 patients with symptomatic LDH were included. Twenty trials performed the comparison between ED and NED. Five trials performed the comparison between percutaneous endoscopic transforaminal discectomy (PETD) and percutaneous endoscopic interlaminar discectomy (PEID). The operative time of micro-endoscopic discectomy (MED) was longer than open discectomy (OD). The length of hospital stay of percutaneous endoscopic lumbar discectomy (PELD) was shorter than fenestration discectomy (FD). Significant differences in intraoperative blood loss volumes were found between PELD with FD and MED with OD. The complication rate of PELD was lower than FD (PELD: 4.3%; FD: 14.6%) and the complication rate of full-endoscopic discectomy (FE) was lower than microscopic discectomy (MD) (FE: 13.4%; MD: 32.1%). Conclusions: PELD and FE have the advantage of limiting intraoperative damages. ED and NED can be both considered sufficient to achieve good clinical outcomes. PETD and PEID are able to achieve similar results but the learning curve of PETD was steeper. More independent high-quality RCTs with sufficiently large sample sizes performing cost-effectiveness analyzes are needed.

scholarly journals Correlation Between Facet Tropism and Lumbar Disc Herniation

2020 ◽  
Author(s):  
Han Ye ◽  
Wang Xiaodong ◽  
Zhang zepei ◽  
Deepak shrestha ◽  
Li Kepeng ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Facet Joint ◽  
Lumbar Disc ◽  
Normal Subjects ◽  
Left And Right ◽  
The Difference ◽  
Facet Tropism ◽  
The Relationship ◽  
Lumbar Facet

Abstract Purpose The relationship between facet tropism (FT) and lumbar disc herniation (LDH) is not clear. In the present study, MRI was used to assess the relationship between lumbar facet joint tropism and disc herniation. This paper is the first to assess the relationship between facet joint tropism and LDH from the sagittal view. Methods 122 patients (154 segments) with lumbar disc herniation and 102 normal subjects (306 segments) who visited our hospital from 01-Jan-2020 to 01-Apr-2020 were included in this study. The axial and sagittal angles of facet joints were measured using an MRI scan. The difference of 10° in facet angles between left and right was defined as lumbar facet tropism. The relationship between the two was analyzed. Results In the axial, 95/154 segments with lumbar disc herniation had FT whereas, 48/258 segments had FT in the normal segments(p<0.01). In the sagittal, 61/154 segments with lumbar disc herniation had FT and 48/306 had FT in the control(p<0.01). Conclusion The proportion of FT is better in patients with lumbar disc herniation, and there is a significant correlation between FT and lumbar disc herniation.

Effects of Myofascial Release Technique on Pain and Disability in Patients with Chronic Lumbar Disc Herniation: A Randomized Trial

2017 ◽  
Vol 27 (04) ◽  
pp. 218-225 ◽  
Author(s):  
Samani Mahbobeh ◽  
Motealleh Alireza ◽  
Yazdani Soheila ◽  
Abbasi Leila
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Functional Disability ◽  
Trigger Point ◽  
Lumbar Disc ◽  
Group Differences ◽  
Myofascial Release ◽  
Release Technique ◽  
The Mean ◽  
The Difference

Abstract Background Disc herniation is one of the factors that causes low back pain (LBP). Objective This study aimed to evaluate the effect of a myofascial release technique on pain and disability in patients with chronic lumbar disc herniation. Method 30 patients with a herniated lumbar disc, divided into 2 groups. One group (n=15) received electrotherapeutic modalities (TENS, pulsed ultrasound, hot packs) in addition to the myofascial release technique (MFR) on trigger points in 9 soft tissue elements. The other group (n=15) received only electrotherapeutic modalities. All patients underwent 10 treatment sessions. In both groups we assessed back and lower extremity pain intensity, functional disability level and trigger point pain threshold before treatment and after 5 and 10 sessions. Results For back pain, the median between-group differences (95% CI) compared to baseline were 2 (1–2) after the 5th session and 2 (1–4) after the 10th session; the difference between the 5th and 10th sessions was 1 (0–2). For functional disability, the mean between-group differences (95% CI) compared to baseline were 5 points (1.8–8.1) after the 5th session and 8.3 points (4.2–12.3) after the 10th session; the difference between the 5th and tenth sessions was 3.34 points (1.02–5.6). For trigger point pain threshold, the mean between-group differences compared to baseline were −1.47 kg/cm2 (−1.7 to − 1.17) after the 5th session and −3.17 (−3.6 to −2.7) after the 10th session; the difference between the 5th and 10th sessions was −1.7 kg/cm2 (−2.04 to −1.3). Conclusion In conclusion, MFR might be an effective treatment for reducing pain and disability in patients with chronic lumbar disc herniation.

scholarly journals Clinical outcomes after minimal-access surgery for recurrent lumbar disc herniation

2003 ◽  
Vol 15 (3) ◽  
pp. 1-4 ◽  
Author(s):  
Hoang Le ◽  
Faheem A. Sandhu ◽  
Richard G. Fessler
Keyword(s):  
Clinical Outcomes ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Length Of Hospital Stay ◽  
Surgical Approaches ◽  
Published Data ◽  
Minimal Access ◽  
Disc Herniations ◽  
Recurrent Lumbar Disc Herniation

Object Experience with minimal-access surgical approaches for revision lumbar surgery has not been previously reported. Methods During a 7-month period, 10 consecutive patients with recurrent disc herniations underwent revision operations in which microendoscopic discectomy (MED) was performed. Perioperative data and clinical outcomes (according to Macnab criteria) were compared with those obtained in 25 consecutive patients who underwent routine single-level MED as well as with previously published data. Overall, outcome of the MED-treated revision group was excellent or good in 90% during a mean follow-up period of 18.5 months (minimum 12 months). Operative blood loss, duration, complications, and length of hospital stay were not significantly different between the revision and primary MED-treated groups. Conclusions Analysis of these early data suggests equivalent or superior results are obtained when performing MED compared with historical controls in which conventional surgery was conducted for recurrent disc surgery. The procedure appears to be a safe and effective alternative in cases in which recurrent lumbar disc herniation causes radiculopathy.

scholarly journals Correlation between facet tropism and lumbar disc herniation

2020 ◽  
Author(s):  
Han Ye ◽  
Wang Xiaodong ◽  
Zhang Zepei ◽  
Deepak Shrestha ◽  
Li Kepeng ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Facet Joint ◽  
Lumbar Disc ◽  
Normal Subjects ◽  
Left And Right ◽  
The Difference ◽  
Facet Tropism ◽  
The Relationship ◽  
Lumbar Facet

Abstract Purpose The relationship between facet tropism (FT) and lumbar disc herniation (LDH) is not clear. In the present study, MRI was used to assess the relationship between lumbar facet joint tropism and disc herniation. This paper is the first to assess the relationship between facet joint tropism and LDH from the sagittal view. Methods 122 patients (154 segments) with lumbar disc herniation and 102 normal subjects (306 segments) who visited our hospital from 01-Jan-2020 to 01-Apr-2020 were included in this study. The axial and sagittal angles of facet joints were measured using an MRI scan. The difference of 10° in facet angles between left and right was defined as lumbar facet tropism. The relationship between the two was analyzed. Results In the axial, 95/154 segments with lumbar disc herniation had FT whereas, 48/258 segments had FT in the normal segments(p < 0.01). In the sagittal, 61/154 segments with lumbar disc herniation had FT and 48/306 had FT in the control(p < 0.01). Conclusion The proportion of FT is better in patients with lumbar disc herniation, and there is a significant correlation between FT and lumbar disc herniation.

scholarly journals Early Experience of Full-Endoscopic Interlaminar Discectomy for Adolescent Lumbar Disc Herniation with Sciatic Scoliosis

2018 ◽  
Vol 1 (21;1) ◽  
pp. E63-E70 ◽  
Author(s):  
Bing Wang
Keyword(s):  
Retrospective Study ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Small Sample Size ◽  
Lumbar Disc ◽  
Length Of Hospital Stay ◽  
Small Sample ◽  
Leg Pain ◽  
Satisfactory Outcome ◽  
The Mean

Background: Full-endoscopic interlaminar discectomy (FEID) has achieved satisfactory outcome in adolescent lumbar disc herniation (ALDH). Sciatic scoliosis is found to be a common presentation in ALDH. However, few reports are focused on the influences of sciatic scoliosis on ALDH and the prognosis of sciatic scoliosis after FEID. Objective: This study aims to evaluate the clinical and radiological results of FEID in the treatment of ALDH with sciatic scoliosis and to identify the effects of sciatic scoliosis on complication and recurrence. Study Design: A retrospective study. Setting: An inpatient surgery center. Methods: A series of cases of patients under age 20 with single-level ALDH that underwent FEID between January 2010 and December 2014 were retrospectively analyzed. The patients were divided into 2 groups according to if they had scoliosis or not. Clinical outcomes were evaluated using a visual analog scale (VAS) for low back and leg pain, Oswestry Disability Index (ODI) for the functional assessment, and modified Macnab criteria for the patient satisfaction. Radiological parameters of the scoliosis group such as Cobb angle, CVSL-max, and CVSL-C7 were statistically analyzed. Results: No significant differences were found between both groups in terms of the mean operative time, the mean length of hospital stay, complications, and recurrences (P > 0.05). VAS and ODI scores were significantly improved in both groups (P < 0.05). However, there were no statistically significant differences between the 2 groups in VAS, ODI, and modified MacNab criteria (P > 0.05). For the scoliosis group, significant improvements were observed in the postoperative sagittal and coronal alignment parameters (P < 0.05). Limitations: This was a retrospective study with a relatively small sample size. Additionally, the length of follow-up was short. Conclusions: The application of FEID in the treatment of ALDH could achieve satisfactory clinical and radiological outcomes. Sciatic scoliosis was corrected spontaneously without increasing the risk of complication and recurrence. Key words: Adolescent lumbar disc herniation, full-endoscopic interlaminar discectomy, sciatic scoliosis, recurrence

scholarly journals Analysis of the Application Value of MRI and CT Diagnosis of Lumbar Disc Herniation

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Lianglong Wu ◽  
Liangjin Liu
Keyword(s):  
Intervertebral Disc ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Intervertebral Disc Herniation ◽  
Ct Diagnosis ◽  
Disc Bulge ◽  
Mri Diagnosis ◽  
The Difference ◽  
Operation Results

Objective: To analyze the application value of MRI and CT diagnosis for those with lumbar disc herniation. Methods: The data of 62 patients with LDH treated in our hospital from January 2019 to December 2019 were analyzed retrospectively. All patients were diagnosed as LDH after operation, and 62 patients were treated with MRI and CT. The accuracy of CT and MRI in the diagnosis was analyzed according to the gold standard of operation results. Results: 62 patients were diagnosed as LDH after operation, including 25 cases with intervertebral disc herniation, 12 cases with intervertebral disc prolapse, 8 cases with intervertebral disc nodule, 7 cases with intervertebral disc dissociation as well as 10 cases with intervertebral disc bulge. The accuracy of MRI diagnosis (95.16%) was higher than that of CT (75.81%), and the difference was statistically significant (P<0.05). Conclusion: For the diagnosis of LDH, MRI is more accurate, but CT is faster and cheaper. Both of them have their own advantages and can be chosen clinically according to the actual situation of patients on the basis of ensuring the diagnostic accuracy.

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