scholarly journals LUMBAR DISCECTOMY

2011 ◽  
Vol 18 (04) ◽  
pp. 678-683
Author(s):  
M.SHAHID SMAIJA ◽  
SHEIKH ATIQ-UR-REHMAN ◽  
ASFA KHIZAR
Keyword(s):  
Lumbar Disc ◽  
Pain Scale ◽  
Mri Findings ◽  
Disc Disease ◽  
Clinical Difference ◽  
Constant Pain ◽  
Endoscopic Discectomy ◽  
Tissue Dissection ◽  
Straight Leg Raising ◽  
Group B

Background: Discectomy is the standard treatment for lumber disc disease. Fenestration operations involved lot of tissue dissection and so the complications. Instead the endoscopic discectomy involved less tissue dissection but limited exposure. Objectives: The objectives of this study were to compare the outcome of endoscopic discectomy and fenestration discectomy interms of relieve from symptoms and complications. Study Design: Analytic study. Place and duration of study: Neurosurgical unit Bahawal Victoria hospital Bahawalpur, from Feb 2010 to Aug 2010. Patients and Methods: Forty cases fulfilling the inclusion criteria were selected. Efficacy of procedure was determined by improvement in Denis pain scale, Macnab’s criteria and straight leg raising (SLR) improvement. Results: Forty patients divided in two equal groups. Patients of group A underwent fenestration and Group B endoscopic discectomy.60%of patients had left sciatica while 40% of patients had right sciatica. According to Denis pain scale 10% patients had moderate pain, 30% had severe pain and 60% had constant pain. Straight leg raising test showed, 50% patients had less than 30O SLR, 30%patients showed SLR of 31̊ to 40̊ and 20%patients had SLR more than 40O. MRI findings were disc bulging, protrusion and rupture. Considering SLR, Denis pain scale and Mcnabs criteria of pain control there was no clinical difference found between the two operative procedures except in two patients in group B when open discectomy had to be performed. Conclusions: MED is a safe and effective mode of treatment for low back pain in patients with lumbar disc herniation. 

Comparison of Outcomes Postoperation between Straight Leg Raising Test Negative and Positive Patients Who Underwent Percutaneous Transforaminal Endoscopic Discectomy for Lumbar Disc Herniation

2019 ◽  
Author(s):  
Feilong Wei ◽  
Haoran Gao ◽  
Yifang Yuan ◽  
Shu Qian ◽  
Quanyou Guo ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Related Factors ◽  
Significant Difference ◽  
Endoscopic Discectomy ◽  
Straight Leg Raising ◽  
Percutaneous Transforaminal Endoscopic Discectomy ◽  
Relevant Factors

Abstract Background: Percutaneous Transforaminal Endoscopic Discectomy is used increasingly in patients with Lumbar Disc Herniation. There is little knowledge on the related factors including SLR test influencing the operation. Therefore, we designed this prospective study to explore the relevant factors influencing postoperative effect of PTED surgery.Methods: Consecutive patients with LDH who came to our hospital from August 2015 to September 2016 and received PTED surgery. 4 kinds of scales including VAS (lumbar/leg), ODI and JOA were measured and reassessed at 1 day, 3 months, 6 months, 12months and 36 months after the PTED to assess their surgical outcomes. Results: All the patients had successful surgery. ODI and VAS (lumbar/leg) decreased in all patients and groups. And there was a statistically significant difference in each postoperative follow-up compared with that before surgery in every visit. In addition, the increase of JOA in postoperation was statistically significant compared with that before surgery. And, there is statistically significant difference between the three subpopulations (patients with SLR Positive (0°-30°), SLR Positive (31°-60°) and SLR Negative (61°-) in the changes of the scores of VAS(leg), ODI and JOA. However, there is no statistically significant difference between the three subpopulations (patients with SLR Positive (0°-30°), SLR Positive (31°-60°) and SLR Negative (61°--RRB- in the changes of the score of VAS(lumbar). Conclusions: PTED showed great effect on treating patients with lumbar disc herniation. And the main scale score such as VAS(leg). ODI and JOA showed that there is a statistically significant difference between the three subpopulations treated by PTED. Patients with SLR negative may get greater benefit from PTED.

scholarly journals Is Endoscopic Discectomy the Next Gold Standard in the Management of Lumbar Disc Disease? Systematic Review and Superiority Analysis

2020 ◽  
pp. 219256822094881
Author(s):  
Sathish Muthu ◽  
Eswar Ramakrishnan ◽  
Girinivasan Chellamuthu
Keyword(s):  
Systematic Review ◽  
Hospital Stay ◽  
Gold Standard ◽  
Lumbar Disc ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Disc Disease ◽  
Lumbar Disc Disease ◽  
Endoscopic Discectomy ◽  
Duration Of Surgery

Study Design: Systematic review and meta-analysis. Objectives: We performed this meta-analysis to evaluate whether endoscopic discectomy (ED) shows superiority compared with the current gold standard of microdiscectomy (MD) in management of lumbar disc disease. Materials and Methods: We conducted independent and duplicate electronic database search including PubMed, Embase, and Cochrane Library from 1990 till April 2020 for studies comparing ED and MD in the management of lumbar disc disease. Analysis was performed in R platform using OpenMeta[Analyst] software. Results: We included 27 studies, including 11 randomized controlled trials (RCTs), 7 nonrandomized prospective, and 9 retrospective studies involving 4018 patients in the meta-analysis. We stratified the results based on the study design. Considering the heterogeneity in some results between study designs, we weighed our conclusion essentially based on results of RCTs. On analyzing the RCTs, superiority was established at 95% confidence interval for ED compared with MD in terms of functional outcomes like Oswestry Disability Index (ODI) score ( P = .008), duration of surgery ( P = .023), and length of hospital stay ( P < .001) although significant heterogeneity was noted. Similarly, noninferiority to MD was established by ED in other outcomes like visual analogue scale score for back pain ( P = .860) and leg pain ( P = .495), MacNab classification ( P = .097), recurrences ( P = .993), reoperations ( P = .740), and return-to-work period ( P = .748). Conclusion: Our meta-analysis established the superiority of endoscopic discectomy in outcome measures like ODI score, duration of surgery, overall complications, length of hospital stay and noninferiority in other measures analyzed. With recent advances in the field of ED, the procedure has the potential to take over the place of MD as the gold standard of care in management of lumbar disc disease.

scholarly journals Results of transforaminal endoscopic discectomy for lumbosacral disc herniation added by nucleoplasty

2021 ◽  
Vol 27 (2) ◽  
pp. 243-248
Author(s):  
M.D. Abakirov ◽  
◽  
O.A. Al-Bawareed ◽  
M.A. Panin ◽  
R.M. Nurmukhametov ◽  
...  
Keyword(s):  
Health Status ◽  
Recurrence Rate ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Pain Scale ◽  
Lumbar Spine Surgery ◽  
Group I ◽  
Endoscopic Discectomy ◽  
Group Ii ◽  
Complete Data Analysis

Introduction Herniated disks are very common. Percutaneous endoscopic lumbar spine surgery for the lumbar disc herniation facilitates minimalized access ports to the operating site with decreased risk of infection, reduced blood loss and less tissue dissection and muscle trauma. The goal was to compare the results of standard transforaminal endoscopic discectomy for lumbosacral herniation and outcomes of the procedure added by nucleoplasty. Material and methods Percutaneous transforaminal endoscopic discectomy was performed for 92 patients and added by nucleoplasty in 43 patients of group I. Preoperative and postoperative evaluation was produced with the Visual Analog Pain Scale (VAS), the Oswestry Low Back Pain Disability Questionnaire (ODI) and the MacNab clinical outcome score. Complication and recurrence rate was reviewed. Microsoft Office Excell and Statistica 8.0 were used to complete data analysis reports. Results VAS scores decreased from 7.9 to 3.1 showing 2.5-fold decrease (p < 0.05), and ODI scores decreased from 71.09 to 18.58) (p < 0.001) demonstrating fourfold decrease at one-year follow-up. There were no significant differences in VAS and ODI scores between the groups preoperatively and postoperatively (p > 0.05). The majority of patients of group I (41.86 %) rated their health status as excellent on the MacNab scale, and the majority of patients of group II (53.06 %) rated their health status as good. Postoperative complication rate was 11.63% in group I and 12.24% in group II (p > 0.05). There was no recurrence in group I with the recurrence rate of 6.1% (p < 0.001) in group II. Conclusion Endoscopic discectomy for lumbosacral herniation supplemented with nucleoplasty can reduce the recurrence rate.

scholarly journals Comparison of Conventional Fenestration Discectomy Versus Percutaneous Transforaminal Endoscopic Discectomy for Treating Lumbar Disc Herniation

2020 ◽  
Author(s):  
Quanyi Li ◽  
yongchun zhou
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Intraoperative Blood Loss ◽  
Endoscopic Discectomy ◽  
Percutaneous Transforaminal Endoscopic Discectomy ◽  
Group A ◽  
Group B

Abstract Purpose: To compare the efficacy of conventional interlaminar fenestration discectomy (IFD) versus percutaneous transforaminal endoscopic discectomy (PTED) for treating lumbar disc herniation (LDH). Methods: The clinical data of 1,100 patients who had been diagnosed with LDH from January 2012 to December 2017 were retrospectively analysed. IFD was performed on the 605 patients in Group A, while PTED was performed on the 505 patients in Group B. The Oswestry Disability Index (ODI), Visual Analogue Scale (VAS) for pain, and modified Macnab criteria were adopted to evaluate the outcomes. Moreover, the surgery durations, intraoperative blood loss, postoperative off-bed activities, and postoperative lengths of hospital stay for the two groups were observed. Results: The follow-up period ranged from 24 months to 60 months, with an average duration of 43 months. As the excellent and good outcome rate was 93.5% in Group A and 92.6% in Group B, there were no significant differences in efficacy between the two groups (P > 0.05). However, Group B had significantly less intraoperative blood loss and shorter bed rest durations and postoperative lengths of hospital stay than did Group A (P < 0.05). There were two cases of postoperative recurrence in Group A and three in Group B. Conclusions: Although conventional IFD and PTED had similar levels of efficacy in treating LDH, transforaminal endoscopic discectomy exhibited several advantages, such as less trauma, less bleeding, and a shorter length of hospital stay, and it can be considered an ideal surgical option for treating LDH.Save and Continue

Relationship between Severity of Lumbar Disc Disease and Disability Scores in Sciatica Patients

Neurosurgery ◽  
2002 ◽  
Vol 50 (6) ◽  
pp. 1253-1260 ◽  
Author(s):  
François Porchet ◽  
Vincent Wietlisbach ◽  
Bernard Burnand ◽  
Karine Daeppen ◽  
Jean-Guy Villemure ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Pain Score ◽  
Odds Ratio ◽  
Lumbar Disc ◽  
Pain Scale ◽  
Leg Pain ◽  
Imaging Findings ◽  
Disc Disease ◽  
Lumbar Disc Disease ◽  
Sf 36

Abstract OBJECTIVE To study the association between the clinical examination and the radiological assessment of lumbar disc disease in patients with sciatica. METHODS The study included 394 consecutive sciatica patients. The patients’ disabilities were evaluated by a visual analog pain scale, the Prolo functional-economic rating scale, the modified Roland-Morris disability questionnaire, and the health-related quality of life short form (SF-36) questionnaire. Radiological imaging findings were independently classified according to the Modic criteria into five groups of increasing severity of disc disease. Stepwise multivariate logistic regression was used to determine which scores were significant independent predictors of a severe disc disease (extrusion or sequestration). RESULTS Of these patients, 9.6% had no disc disease, 3.3% had a bulging, 11.4% had a protrusion, 68.5% had an extrusion, and 7.1% had a disc sequestration. Statistically significant positive linear associations with the severity of disc disease were found for the leg pain scale, the Roland-Morris and Prolo disability scales, and the SF-36 scores related to physical functioning, physical role, and bodily pain (all P &lt; 0.005). A poor (&lt;5) Prolo score (odds ratio, 2.91; 95% confidence interval, 1.74–4.87), a higher leg pain score (odds ratio, 1.16 per centimeter increase; 95% confidence interval, 1.07–1.27), and a lower low back pain score (odds ratio, 0.90 per centimeter decrease; 95% confidence interval, 0.82–0.98) were retained in the multivariate logistic model as independent predictors of severe disc disease. CONCLUSION The positive correlation between disability status and imaging findings validates both assessment methods. Routine use of disability scores brings a useful contribution to the assessment of sciatica patients.

Current Concepts in Minimally Invasive Discectomy

Neurosurgery ◽  
2002 ◽  
Vol 51 (suppl_2) ◽  
pp. S2-137-S2-145 ◽  
Author(s):  
Joseph C. Maroon
Keyword(s):  
Minimally Invasive ◽  
Lumbar Disc ◽  
Surgical Approaches ◽  
Minimally Invasive Procedures ◽  
Success Rates ◽  
Invasive Procedures ◽  
Disc Disease ◽  
Lumbar Disc Disease ◽  
Endoscopic Discectomy ◽  
Microendoscopic Discectomy

Abstract OBJECTIVE The purpose of this study was to evaluate the various minimally invasive procedures available for the treatment of lumbar disc disease. METHODS A review of the literature, as well as my personal experience with minimally invasive approaches to the lumbar discs, was performed. This review included the percutaneous and open surgical approaches currently available and used for the treatment of lumbar disc disease. RESULTS The primary minimally invasive procedures for the treatment of lumbar disc disease include the following: 1) chemonucleolysis, introduced by Lyman Smith in 1964; 2) percutaneous manual nucleotomy, introduced by Hijikata in 1975; 3) microdiscectomy, first performed by Yaşargil in 1968; 4) automated percutaneous lumbar discectomy, introduced by Onik in 1984; 5) laser discectomy, first performed by Ascher and Choy in 1987; 6) endoscopic discectomy, first used by Schreiber and Suezawa in 1986 and improved by Mayer, Brock, and Mathews; 7) microendoscopic discectomy, introduced by Smith and Foley in 1995; and 8) intradiscal electrothermy, first reported by Saal and Saal in 2000. CONCLUSION Although all percutaneous techniques have been reported to yield high success rates, to date no studies have demonstrated any of these to be superior to microsurgical discectomy, which continues to be regarded as the standard with which all other techniques must be compared.

scholarly journals Comparison of Conventional Fenestration Discectomy with Percutaneous Transforaminal Endoscopic Discectomy for Treating Lumbar Disc Herniation:Maximum 5 year follow-up in 1,100 patients

2020 ◽  
Author(s):  
Quanyi Li ◽  
yongchun zhou
Keyword(s):  
Hospital Stay ◽  
Lumbar Disc ◽  
Length Of Hospital Stay ◽  
Bed Rest ◽  
Endoscopic Discectomy ◽  
Percutaneous Transforaminal Endoscopic Discectomy ◽  
Postoperative Length ◽  
Group A ◽  
Group B

Abstract Purpose: To compare the efficacy of conventional interlaminar fenestration discectomy (IFD) with percutaneous transforaminal endoscopic discectomy (PTED) for treating lumbar disc herniation (LDH). Methods: The clinical data of 1,100 patients who had been diagnosed with LDH between January 2012 and December 2017 were retrospectively analysed. IFD was performed on 605 patients in Group A, whereas PTED was performed on 505 patients in Group B. The Oswestry Disability Index, Visual Analogue Scale for pain and modified MacNab criteria were used to evaluate the outcomes. The surgery duration, intraoperative blood loss, postoperative off-bed activity and postoperative length of hospital stay were recorded. Results: The follow-up period ranged from 24 to 60 months, with an average of 43 months. The excellent and good outcome rates were 93.5% in Group A and 92.6% in Group B. There was no significant difference in efficacy between the groups (P > 0.05). However, Group B had significantly less intraoperative blood loss and shorter bed rest duration and postoperative length of hospital stay than Group A (P < 0.05). There were two cases of postoperative recurrence in Group A and three in Group B. Conclusions: Although conventional IFD and PTED had similar levels of efficacy in treating LDH, PTED had several advantages. There was less intraoperative bleeding, shorter length of hospital stay and shorter bed rest duration. It can be considered a safe and effective surgical option for treating LDH.

The level of pain intensity vs sleep quality and functioning of patients with cervical and lumbar disc disease

Ból ◽  
2016 ◽  
Vol 17 (3) ◽  
pp. 19-25
Author(s):  
Lucyna Tomaszek ◽  
Grażyna Cepuch ◽  
Beata Piórko
Keyword(s):  
Sleep Quality ◽  
Pain Intensity ◽  
Everyday Life ◽  
Pain Treatment ◽  
Clinical Symptoms ◽  
Lumbar Disc ◽  
Disease Process ◽  
Disc Disease ◽  
Constant Pain ◽  
Degree Of Disability

Discopathy have wide variety of clinical symptoms. The main issue, destabilizing patients’ life is pain, especially when sleep quality is influenced. The aim of the study was to assess the influence of pain severity on sleep and everyday life quality in patients with cervical and lumbar discopathy. The study was performed on 52 cervical herniation and 59 lumbar herniation patients qualified to surgical intervention. In the study, Athens Insomnia Scale, Oswestra Questionnaire, NRS were used. The majority of patients (70,3%) experienced constant pain and it’s severity what is higher in group of patients with lumbar herniation (Me: 8 vs 7; p=0,036). In a 41% of patients pain lasted for more than two years. Analgesics were applayed by patients (73%) most temporarily, when the level of pain was 8 (relief of pain Me: 5). The pain intensity is correlated with insomnia (r=0,32; p=0,000) and degree of disability (r=0,60; p=0,000). Patients with lumbar herniation have significantly higher degree of disability in comparison to patients with cervical herniation (49,9% vs 37,4%; p=0,000). In majority of patients experienced pain was constant and its intensity was high. Moreover pain was responsible for lowering the quality of sleep and everyday life regardless of the patient’s age. Patients with lumbar herniation experienced significantly higher pain intensity and had higher degree of disability. The pain treatment was not effective enough however it’s effectiveness can be modified by many factors, not by disease process itself.

scholarly journals Long term results of Endoscopic Lumbar Discectomy using Side viewing Conical working tube

2018 ◽  
Vol 32 (2) ◽  
pp. 306-313
Author(s):  
Mohammad Kaif ◽  
Kuldeep Yadav ◽  
Mazhar Husain
Keyword(s):  
Low Cost ◽  
Lumbar Disc ◽  
Early Mobilization ◽  
Long Term Results ◽  
Disc Disease ◽  
Lumbar Disc Disease ◽  
Endoscopic Discectomy ◽  
Endoscopic Lumbar Discectomy

Abstract Object: Endoscopic discectomy is a common procure performed worldwide with various devices being used and studies have reported their long term results. In this study we present the long term results of the unique device with separate side viewing channel. Methods: 66 patients of lumbar disc herniation treated between March 2009 to April 2012 using the unique conical working tube with separate side viewing endoscopic channel. Their preoperative and postoperative Oswestry Disability Index (ODI) and Macnab scores were used to evaluate the outcome after a minimum follow of 5 years with mean follow up of 76.18 months. Results: There were 46 males and 20 females with age ranging from19-72 (mean-38.4 years). The follow up ranged from 61 months to 95 months with mean of 76.18 months. The mean preoperative ODI score was 74.7 which decreased to a mean of 7.8 and the outcome evaluated by Macnab criteria was 69.69% excellent, 17 % good, 10% fair, 3.03% poor. 2 patients underwent second surgery. None of the patient had to change their occupation due to their lumbar disc disease. Complications occurred were dural tear in 2 patients, transient foot paresis in 1 patient and 1 discitis in 1 patient which improved on medical management. Conclusion: Endoscopic discectomy using thins Conical working tube is a safe and effective technique for lumbar disc prolapse. It has the advantage for early mobilization, short hospital stay and low cost. The long term results are comparable to the conventional techniques.

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