scholarly journals Postoperative pain management for single-level lumbar disc herniation surgery: a comparison of betamethasone, ibuprofen and pregabalin

2020 ◽  
Author(s):  
Emre Bilgin
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Postoperative Pain Management ◽  
Single Level

Early Outcomes: A Comparison between Biportal Endoscopic Spine Surgery and Open Lumbar Discectomy for Single-Level Lumbar Disc Herniation

2021 ◽  
Vol 104 (1) ◽  
pp. 123-128
Keyword(s):  
Postoperative Pain ◽  
Lumbar Disc Herniation ◽  
Spine Surgery ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Hospital Costs ◽  
Lumbar Discectomy ◽  
Morphine Consumption ◽  
Single Level ◽  
Endoscopic Spine Surgery

Objective: To compare early outcomes between biportal endoscopic spine surgery (BESS) and open lumbar discectomy (OLD) for treating single-level lumbar disc herniation. Materials and Methods: A retrospective cohort study was conducted in 80 cases of single-level lumbar disc herniation that underwent either BESS or OLD. The author compared the perioperative data between BESS and OLD, including operative time (OT), level, side, estimated blood loss (EBL), surgical drain output, hospital stay (HS), hospital costs, visual analogue scale (VAS) scores, morphine consumption, complication, and McNab’s satisfaction outcome. Results: Forty-three patients underwent BESS and 37 underwent OLD. There was 55% female and 45% male. The mean age was 37.8±9.5 years. The BESS group showed significantly (a) lower median morphine consumption than the OLD group (five mg versus nine mg, p<0.001), (b) lower postoperative pain (VAS) at 2-, 4-, 12-, 24-, 48- (p<0.001), and 72-hours post-surgery (p=0.017), and (c) shorter HS (4.8±2.9 days versus 7.4±4.6 days, p=0.003). McNab’s satisfaction outcome of a good or excellent result was comparable between BESS and OLD group (97.7% versus 86.5%, p=0.090). The BESS group, however, had a longer OT than the OLD group (100.4±28.5 versus 67.9±23.2 minutes, p<0.001), and had a higher hospital cost (1,256±360.9 USD versus 910.6±269.8 USD, p<0.001). Complications were not significantly different between the BESS and OLD groups. Conclusion: BESS for single-level lumbar discectomy had less postoperative pain for up to 72 hours, less opioid consumption, and shorter HS, but longer OT and higher hospital costs than OLD. Patient satisfaction outcomes were comparable between the two groups. Keywords: Biportal endoscopic spine surgery, Unilateral biportal endoscopic discectomy, Open lumbar discectomy, Single-level lumbar disc herniation

464 CAUDA EQUINA SYNDROME SECONDARY TO LUMBAR DISC HERNIATION: PITFALLS IN CLINICAL PAIN MANAGEMENT

2009 ◽  
Vol 13 (S1) ◽  
Author(s):  
R. Mestrum ◽  
P. Vooght ◽  
P. Vanelderen ◽  
M. Puylaert ◽  
G. Hans ◽  
...  
Keyword(s):  
Pain Management ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Cauda Equina Syndrome ◽  
Lumbar Disc ◽  
Cauda Equina ◽  
Clinical Pain

scholarly journals Transforaminal percutaneous endoscopic lumbar discectomy versus microdiscectomy: an Indian rural experience

2017 ◽  
Vol 3 (6) ◽  
pp. 1141
Author(s):  
Prakash U. Chavan ◽  
Mahendra Gudhe ◽  
Ashok Munde ◽  
Balaji Jadhav
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Operating Time ◽  
Lumbar Discectomy ◽  
Leg Pain ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Single Level ◽  
Group I ◽  
Endoscopic Lumbar Discectomy

<p class="abstract"><strong>Background:</strong> The objective of the study was to compare surgical outcome of micro-discectomy with transforaminal percutaneous endoscopic lumbar discectomy for single level lumbar disc herniation in Indian rural population.</p><p class="abstract"><strong>Methods:</strong> Retrospective comparative study was designed during the period of October 2012 to June 2015, patients in the age group of 22-75 years with unremitting sciatica with/without back pain, and/or a neurological deficit that correlated with appropriate level and side of neural compression as revealed on MRI, with single level lumbar disc herniation who underwent either microdiscectomy or TPELD were included in the study. Patients were assessed on visual analogue scale (VAS) for back and leg pain, modified macnabs criteria, the Oswestry Disability Index (ODI).<strong></strong></p><p class="abstract"><strong>Results:</strong> Group I (MD) included 44 patients and Group II (TPELD) included 20 patients. Significant improvement was seen in claudication symptom post-operatively in both MD and TPELD. Mean operating time was significantly shorter in MD group (1.11 hrs vs. 1.32 hrs; p&lt;0.01). According to modified MacNab's criteria,<strong> </strong>outcome were excellent (81.8%), good (9.09%) and fair<strong> </strong>(9.09%) in MD. Similarly, in TPELD, 80%, 15% and 5% patients had excellent, good and fair outcome respectively. In both groups, no one had a poor outcome. Thus, overall success rate was 100% in the study.</p><strong>Conclusions:</strong> TPELD and MD have comparable post-operative outcome in most of the efficacy parameters in Indian rural patients undergoing treatment of single level lumbar disc herniation. Additionally, TPELD offers distinct advantages such as performed under local anaesthesia, preservation of structure, lesser post-operative pain and early mobilization and discharge from hospital.

scholarly journals Evaluation of the effectiveness of surgical methods for the treatment of recurrent lumbar disc herniation: a cohort retrospective study

2021 ◽  
Vol 18 (2) ◽  
pp. 34-43
Author(s):  
M. N. Kravtsov ◽  
I. A. Kruglov ◽  
S. D. Mirzametov ◽  
A. S. Seleznev ◽  
N. P. Alekseyeva ◽  
...  
Keyword(s):  
Intervertebral Disc ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Interbody Fusion ◽  
Lumbar Disc ◽  
Disc Replacement ◽  
Single Level ◽  
Surgical Methods ◽  
Endoscopic Discectomy ◽  
Recurrent Lumbar Disc Herniation

Objective. To compare the effectiveness of surgical methods for treating patients with recurrent lumbar disc herniation.Material and Methods. The sample consisted of 160 patients operated on in 2014–2019 for recurrent lumbar disc herniation by percutaneous endoscopic discectomy (Group 1), microsurgical discectomy (Group 2), single-level transforaminal interbody fusion (Group 3) and single-level total intervertebral disc replacement (Group 4). The effectiveness of surgical treatment was evaluated using the NRS-11, ODI, and MacNab questionnaires.Results. Assessment of the pain syndrome severity and the vital activity level of patients revealed significant (p < 0.05) differences in favor of total intervertebral disc replacement. Excellent and good outcomes after arthroplasty according to MacNab criteria were noted in all patients in this group. Similar outcomes were reported in 77.5 % (31/40) of patients in the TLIF group, in 75.1 % (24/32) of patients in the percutaneous endoscopic discectomy group and in 72.6 % (45/62) of patients in the microdiscectomy group. The operation time and length of hospital stay were shorter in the endoscopic and microsurgical discectomy groups (p < 0.001). However, the lower incidence of complications and reoperations was observed in groups of posterior interbody fusion and arthroplasty (p > 0.05).Conclusion. Arthroplasty with the M6-L implant expands the possibilities of surgery for recurrent lumbar disc herniation. Total intervertebral disc replacement and posterior interbody fusion for recurrent lumbar disc herniation are more effective in comparison with decompressive operations, which is reflected in the improvement of clinical treatment outcomes, reduction of perioperative complications and frequency of repeated interventions.

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