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

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.

2020 ◽  
Vol 13 (1) ◽  
pp. 41-47
Author(s):  
Mladen E. Ovcharov

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.


2019 ◽  
Vol 12 (2) ◽  
pp. 139-146
Author(s):  
Mladen E. Ovcharov ◽  
Iliya V. Valkov ◽  
Milan N. Mladenovski ◽  
Nikolay V. Vasilev

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.


2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Albert E. Telfeian ◽  
Adetokunbo Oyelese ◽  
Jared Fridley ◽  
Rohaid Ali ◽  
Deus Cielo ◽  
...  

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.


1985 ◽  
Vol 34 (1) ◽  
pp. 372-378
Author(s):  
Kazumori Arimura ◽  
Ken Takara ◽  
Hiroshi Fukuyama ◽  
Masatoshi Matsuoka

1995 ◽  
Vol 133 (1-2) ◽  
pp. 7-12 ◽  
Author(s):  
E. Kotilainen ◽  
A. Alanen ◽  
R. Parkkola ◽  
H. Helenius ◽  
S. Valtonen ◽  
...  

2003 ◽  
Vol 17 (2) ◽  
pp. 113-118
Author(s):  
Kinya Nakanishi ◽  
Junya Hanakita ◽  
Yoshihiro Kawahara ◽  
Tsukasa Satou ◽  
Masashi Oda ◽  
...  

2021 ◽  
Author(s):  
Christian Christensen Støttrup ◽  
Caius Constantinescu ◽  
Reza Piri ◽  
Mohsen Khosravi ◽  
Andrew Newberg ◽  
...  

Abstract We hypothesised that unilateral leg pain following surgical treatment of lumbar disc herniation (LDH) is associated with an increase in the glucose metabolism of the contralateral thalamus. Patients scheduled for surgery due to LDH underwent 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) less than two weeks prior to surgery. Their thalamic FDG uptake was measured and expressed as the mean and partial volume corrected mean standardized uptake values (SUVmean and cSUVmean). These measures were compared with patient-related outcome measures collected pre- and 1-year postoperatively: back and leg pain on a 0-100 VAS scale and health related quality of life as measured by the EuroQol-5D (EQ-5D). Twenty-six patients (10 females) aged 49.7 ± 7.4 (mean ± SD) years were included. There was a significant correlation between painful body side and increased contralateral thalamic uptake of FDG, with regard to cSUVmean values. Correlation analyses including clinical parameters and cSUVmean indicated some association with 1-year change in EQ-5D. These preliminary data sustain the hypothesis that unilateral pain in patients with LDH is associated with increased glucose metabolism in the contralateral thalamus, suggestion a central role of thalamus in chronic pain perception.


Sign in / Sign up

Export Citation Format

Share Document