Automated Percutaneous Discectomy: A Prospective Multi-Institutional Study

Abstract A prospective multi-institutional study was carried out to evaluate automated percutaneous discectomy in the treatment of lumbar disc herniations. Of the 327 patients who prospectively met the study criteria and were followed for longer than 1 year, 75.2% were successfully treated. When patients (n = 168) who prospectively did not meet the study criteria were treated, the success rate was 49.4%. One case of discitis was reported; otherwise, no other serious complications were noted, and specifically no vascular or nerve damage was encountered. This study indicates that automated percutaneous discetomy can be used successfully to treat lumbar disc herniations with minimal morbidity and emphasizes the need for proper patient selection.

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Lateral Talocalcaneal Angle in Assessment of Subtalar Valgus: Follow-up of Seventy Grice-Green Arthrodeses

Foot & Ankle ◽

10.1177/107110078300400202 ◽

1983 ◽

Vol 4 (2) ◽

pp. 56-63 ◽

Cited By ~ 38

Author(s):

James Aronson ◽

James Nunley ◽

Karl Frankovitch

Keyword(s):

Success Rate ◽

Patient Selection ◽

Operative Techniques ◽

Reliable Measurement ◽

Subtalar Arthrodesis ◽

Proper Patient Selection ◽

Selection And Assessment

To determine whether definitive radiographic criteria could be elucidated tor the Grice-Green extra-articular subtalar arthrodesis, all 70 cases performed at the Shri-ner's Hospital for Crippled Children, Erie, Pennsylvania, from 1972 to 1980 were reviewed. Patients were followed both clinically and radiographically an average of 4 years and 11 months. Major conclusions were as follows: 1) the standing lateral talocalcaneal angle is the most reliable measurement for operative selection and assessment of postoperative success; and 2) by using strict operative techniques and proper patient selection, a 90% success rate can be expected.

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Classical open lumbar laminectomy and discectomy for disc herniations among manual labourers in India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20175127 ◽

2017 ◽

Vol 5 (12) ◽

pp. 5156

Author(s):

Surendra Kumar Chellarapu ◽

Satya Vara Prasad Kadali ◽

Raja Sekhar B. ◽

Raman B. V. S.

Keyword(s):

Success Rate ◽

Lumbar Disc ◽

Gait Training ◽

Herniated Disc ◽

Canal Diameter ◽

Adjacent Disc ◽

Strenuous Work ◽

Fibrotic Scar ◽

Disc Herniations ◽

History Of

Background: Lumbar disc herniations are most common at L4/5 and L5/S1 levels and this is most prevalent condition among manual laborers. The aim of the study to analyze the clinical presentation, age and sex distribution, immediate postoperative complications and long-term complications/recurrence of symptoms and to formulate recommendations to avoid complications and recurrence of symptoms.Methods: This is a retrospective study which includes 250 patients operated for lumbar disc herniations at L4/5 and L5/S1 levels. A detailed history of presenting complaints, clinical examination and corresponding findings on imaging are correlated. In all these patients, there was severe symptomatology with failed conservative management which necessitated classical open lumbar laminectomy and discectomy. These patients were followed for a period of 5 to 10 years.Results: Assessment of outcome was done using the modified Macnab criteria. The overall success rate was 96% in our series. Post operatively, 9.2% of them experienced localized low back pain which is mild to moderate and being treated with NSAIDS and exercises. 2.4% developed residual disc herniation or hypertrophic fibrotic scar at the operated site which needed surgical intervention. 2% developed spondylolysis and spondylolesthesis at the level of previous surgery, and 4.4% developed adjacent disc herniations.Conclusions: The overall success rate was 96% in our series. In addition to removal of herniated disc other compressing elements like hypertrophied Ligamentumflavum, facet arthropathy and narrowed spinal canal diameter are also addressed with open procedure. To prevent later complications, these patients are supposed to avoid strenuous work, lifting weights, torsion and jerky movements, faulty posture at work and rest, gait training, crouching, sitting on the floor and haunches.

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Lumbar Disc Herniations 'To Operate or Not' Patient Selection and Timing of Surgery

Korean Journal of Spine ◽

10.14245/kjs.2014.11.4.255 ◽

2014 ◽

Vol 11 (4) ◽

pp. 255 ◽

Cited By ~ 2

Author(s):

Gazanfar Rahmathulla ◽

Kambiz Kamian

Keyword(s):

Patient Selection ◽

Lumbar Disc ◽

Timing Of Surgery ◽

Disc Herniations

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Percutaneous Discectomy: An Alternative to Chemonucleolysis?

Neurosurgery ◽

10.1227/00006123-198311000-00010 ◽

1983 ◽

Vol 13 (5) ◽

pp. 542-547 ◽

Cited By ~ 48

Author(s):

William A. Friedman

Keyword(s):

Selection Process ◽

Lumbar Disc ◽

Radiographic Examination ◽

Low Back ◽

University Of Florida ◽

Radiographic Findings ◽

Percutaneous Discectomy ◽

Disc Herniations ◽

A New Technique ◽

The University

Abstract At the University of Florida, a new technique for lumbar disc removal, called percutaneous discectomy, has been explored. This procedure may be performed under general or local anesthesia, frequently takes less than 15 minutes, and is generally bloodless. The patient selection process and the surgical technique are presented in detail. A total of nine patients have undergone percutaneous discectomy. Seven had clear radiculopathies with appropriate radiographic findings, and they all have had excellent relief of symptoms. Two patients presented with intractable low back pain, bilateral mechanical findings, and central disc herniations on radiographic examination. One experienced good relief and one did not. Three patients had several days of paraspinous spasm after the procedure, and one complained of a lower extremity dysesthetic sensation that persisted for several weeks after operation. Our early experience with percutaneous discectomy suggests that it is a technically easy procedure that may prove, in carefully selected cases, to be a viable alternative to other discectomy techniques.

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Should Sequential Bilateral Total Knee Arthroplasty Be Limited to Patients Younger than 80? A Two-Arm Propensity Matched Study

The Journal of Knee Surgery ◽

10.1055/s-0040-1712100 ◽

2020 ◽

Author(s):

Antonio Klasan ◽

Sven Edward Putnis ◽

Wai Weng Yeo ◽

Darli Myat ◽

Brett Andrew Fritsch ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Patient Selection ◽

Knee Arthroplasty ◽

Major Complication ◽

The Elderly ◽

Complication Rates ◽

Bilateral Total Knee Arthroplasty ◽

Proper Patient Selection ◽

Patient Reported ◽

Total Knee

AbstractDespite multiple studies, there remains a debate on the safety of bilateral total knee arthroplasty (BTKA) in the average age patient, with a paucity of data on the outcome of BTKA in an elderly population. This study included 89 patients aged 80 years and older undergoing sequential BTKA over 14 years were identified in a prospectively collected database. Two matched comparison groups were created: patients under 80 undergoing sequential BTKA and patients over 80 undergoing unilateral TKA (UTKA). An analysis of complications, mortality, revision, and patient-reported outcome measures was performed. Mean age of the elderly cohorts was similar: 82.6 for BTKA and 82.9 for UTKA. The average age BTKA cohort had a mean age of 69.1. Complication rates were higher in bilateral cohorts, more so in the elderly BTKA cohort. Pulmonary embolism (PE) was observed in bilateral cohorts only. In these patients, history of PE and ischemic heart disease was a strong predictive factor for developing a major complication. There was no difference in revision rates and infection rates between the three cohorts, and no difference in patient survivorship between the two elderly cohorts. Through the combination of low revision and high survivorship rates and comparable clinical outcomes, this article demonstrates that simultaneous BTKA is an appropriate option to consider for an elderly patient, with proper patient selection and perioperative management. The demonstrated risk groups show that emphasis on patient selection should be focused on medical history rather than chronological age.

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