Long-term outcome of lumbar disc surgery: an experience from Pakistan

2010 ◽  
Vol 12 (6) ◽  
pp. 666-670 ◽  
Author(s):  
Ahmed Bakhsh
Keyword(s):  
Pain Relief ◽  
Lumbar Disc ◽  
Foot Drop ◽  
Neurological Deficits ◽  
Leg Pain ◽  
Lumbar Disc Surgery ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Disc Surgery

Object The author conducted a study to determine the long-term outcome of lumbar disc surgery on relief of sciatic leg pain. Methods This was a retrospective observational study conducted at Fauji Foundation Hospital, Rawalpindi, Pakistan. The author reviewed medical records of 68 patients who underwent lumbar disc surgery for sciatic pain during the period 1995–2004. All patients were physically examined and interviewed. Results Lumbar disc surgery yielded complete pain relief in 79.41% of the cases. In 14.7% of the cases surgery failed to give any pain relief, and in 5.88% it yielded partial pain relief. At up to 10 years postoperatively, 27.77% of patients remained absolutely pain free. Pain recurred in 12.82% of cases after 1 year, in 35.89% during the first 5 years, and in 51.28% after 10 years. Pain recurred in the same leg in 63.88%, in the contralateral leg in 19.44%, and in both legs in 16.66%. Neurological deficits did not improve in any case except in 1 case of foot drop. New neurological deficits developed postoperatively in 8.82% of cases in the form of foot drop and calf muscle weakness. Conclusions Surgery provided immediate pain relief in 79.41% of cases, but the long-term outcome of lumbar disc surgery was not satisfactory.

scholarly journals A Retrospective Observational Analysis on the Outcome of Microlumbar Discectomy among 70 Consecutive Cases in the Tertiary Care Spine Center in Nepal

2019 ◽  
Vol 16 (3) ◽  
pp. 34-39
Author(s):  
Binod Bhattarai ◽  
Shashi Bhushan Sah
Keyword(s):  
Wound Infection ◽  
Lumbar Disc ◽  
Tertiary Care ◽  
Lumbar Discectomy ◽  
Neurological Deficits ◽  
Disc Disease ◽  
Term Outcome ◽  
Lumbar Disc Disease ◽  
Long Term Outcome

Lumbar disc disease is a commonly encountered spine problem. There have been various modalities of treatment that have evolved over the years. The objective of our study is to analyze safety, efficacy, and complications following Micro-lumbar discectomy. All the cases admitted in our spine clinic with symptomatic lumbar disc and who underwent Micro-lumbar discectomy between February2013 to February 2018 were included in our study. Seventy cases were operated during this period. Total operative time, immediate and long term outcome with regards to pain and neurological deficits were tabulated and analyzed for each patient. Furthermore, short and long term complications including wound infection, discit is, instability and recurrence at the same level were also studied and compared with similar studies from the literature. None of our cases had complications related to wound infection, instability or post-operativediscitis. Immediate relief from the radicular pain experienced in the pre-operative period was seen in all patients (Visual analog scale) though benign tingling sensation persisted in a few of them that improved in a short span of time. Recurrence was seen in only one case. Micro-lumbar discectomy is a minimally invasive spine procedure conferring high benefits to the patients. While compared to other methods of intervention, it has a low risk of complications as well as chances of disc recurrences.

THE ROLE OF LOCAL SOLU-MEDROL IN POSTOPERATIVE PAIN RELIEF AFTER LUMBAR DISC SURGERY

2011 ◽  
pp. 40-44
Author(s):  
Keyword(s):  
Back Pain ◽  
Pain Relief ◽  
Lumbar Disc ◽  
Early Postoperative Period ◽  
Leg Pain ◽  
Lumbar Disc Surgery ◽  
Control Group ◽  
Steroid Group ◽  
Disc Surgery

Objectives: The aim of this study is to evaluate analgesic effect of local Solu-Medrol in following lumbar disc surgery. Methods: A prospective, randomized case-control study included 49 patients, divided into 2 groups (24: control group, 25: steroid group). After discectomy, a piece of gelfoam soaked with 40 mg Solu-Medrol was left on the affected root in the steroid group. In the control group, saline soaked gelfoam was applied to the nerve root. T test to compare VAS between the two groups. Results: 24 patients (15 males, 9 females) average age of 30.2 in the control group, 25 patients (18 males, 7 females) average aged 29.8 in the steroid group. Average follow-up time 14.5 months for the control group, 14.2 months for the steroid group. Statistically significant back pain and leg pain relief (p<0.01) was observed at 1 week, 2 weeks and 1 month, but it became insignificant after 3 months. Without any complications could be related to the steroid. Conclusions: Local Solu-Medrol 40 mg is a safe and effective method in reducing back pain and radicular leg pain in early postoperative period. Key words: Local Solu-Medrol; Lumbar disc surgery.

scholarly journals Percutaneous Lumbar Disc Decompression Using the Dekompressor: A Prospective Long-Term Outcome Study

Pain Medicine ◽  
2016 ◽  
pp. pnv122 ◽  
Author(s):  
Zachary L. McCormick ◽  
Curtis Slipman ◽  
Ashot Kotcharian ◽  
Akhil Chhatre ◽  
Frank J Bender ◽  
...  
Keyword(s):  
Lumbar Disc ◽  
Outcome Study ◽  
Term Outcome ◽  
Long Term Outcome

Microsurgical infrapedicular paramedian approach for retrovertebral lumbar disc herniations

2005 ◽  
Vol 2 (1) ◽  
pp. 88-91 ◽  
Author(s):  
Nedal Hejazi
Keyword(s):  
Facet Joint ◽  
Lumbar Disc ◽  
Clinical Results ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Content Type ◽  
Clinical Benefits ◽  
Disc Herniations ◽  
Fine Print

✓ The author performed a microsurgical infrapedicular paramedian approach in 35 patients (23 men and 12 women) to remove herniated lumbar retrovertebral discs that did not have an apparent origin at either the superior or inferior disc level. The goal of this surgery was to minimize the bone resection, preserve the facet joint, and avoid the risk of secondary vertebral instability. The Macnab outcome classification was used to assess all patients who attended follow-up examination for at least 15 months. The clinical results were excellent or good in 34 (97%) of 35 cases. This minimally invasive lumbar spine technique resulted in minimal morbidity, excellent clinical benefits, and a long-term outcome without evidence of secondary segmental instability.

scholarly journals Cavernous Malformation of Brainstem, Thalamus, and Basal Ganglia

Neurosurgery ◽  
2012 ◽  
Vol 72 (4) ◽  
pp. 573-589 ◽  
Author(s):  
Paritosh Pandey ◽  
Erick M. Westbroek ◽  
Peter A. Gooderham ◽  
Gary K. Steinberg
Keyword(s):  
Basal Ganglia ◽  
Neurological Deficits ◽  
Term Outcome ◽  
Cavernous Malformations ◽  
Long Term Outcome ◽  
Brain Malformations ◽  
Hemorrhage Risk ◽  
Clinical Records

Abstract BACKGROUND: Cavernous malformations (CMs) in deep locations account for 9% to 35% of brain malformations and are surgically challenging. OBJECTIVE: To study the clinical features and outcomes following surgery for deep CMs and the complication of hypertrophic olivary degeneration (HOD). METHODS: Clinical records, radiological findings, operative details, and complications of 176 patients with deep CMs were reviewed retrospectively. RESULTS: Of 176 patients with 179 CMs, 136 CMs were in the brainstem, 27 in the basal ganglia, and 16 in the thalamus. Cranial nerve deficits (51.1%), hemiparesis (40.9%), numbness (34.7%), and cerebellar symptoms (38.6%) presented most commonly. Hemorrhage presented in 172 patients (70 single, 102 multiple). The annual retrospective hemorrhage rate was 5.1% (assuming CMs are congenital with uniform hemorrhage risk throughout life); the rebleed rate was 31.5%/patient per year. Surgical approach depended on the proximity of the CM to the pial or ependymal surface. Postoperatively, 121 patients (68.8%) had no new neurological deficits. Follow-up occurred in 170 patients. Delayed postoperative HOD developed in 9/134 (6.7%) patients with brainstem CMs. HOD occurred predominantly following surgery for pontine CMs (9/10 patients). Three patients with HOD had palatal myoclonus, nystagmus, and oscillopsia, whereas 1 patient each had limb tremor and hemiballismus. At follow-up, 105 patients (61.8%) improved, 44 (25.9%) were unchanged, and 19 (11.2%) worsened neurologically. Good preoperative modified Rankin Score (98.2% vs 54.5%, P = .001) and single hemorrhage (89% vs 77.3%, P &lt; .05) were predictive of good long-term outcome. CONCLUSION: Symptomatic deep CMs can be resected with acceptable morbidity and outcomes. Good preoperative modified Rankin Score and single hemorrhage are predictors of good long-term outcome.

scholarly journals The Long-Term Outcome of 3-Dimensional CT-Guided Percutaneous Radiofrequency Thermocoagulation for Tumor-Related Trigeminal Neuralgia

2019 ◽  
Vol 5 (22;5) ◽  
pp. E467-E475
Author(s):  
Luo Fang
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Small Sample ◽  
Cochrane Library ◽  
Gasserian Ganglion ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Ct Guided ◽  
Radiofrequency Thermocoagulation

Background: Percutaneous radiofrequency thermocoagulation (PRFT) has been widely used to treat trigeminal neuralgia. By querying MEDLINE, EMBASE, and the Cochrane Library, no study has reported the long-term outcome of PRFT for tumor-related trigeminal neuralgia (TRTN). Objectives: In this study, we aimed to evaluate the long-term efficacy and safety of PRFT as an alternative treatment for TRTN. Study Design: A retrospective study. Setting: The interventional pain management center in Beijing Tiantan hospital. Methods: We retrospectively analyzed data of all patients who underwent PRFT applied to the Gasserian ganglion under computed tomography guidance for TRTN through a combination of available institutional electronic medical records, patient notes, and radiologic images. Results: Among 38 patients with PRFT treated between March 2007 and February 2018, 13 patients were men and 25 were women. All patients were evaluated as modified Barrow Neurological Institute (BNI) IV-V before the operation and had a total symptom duration of 45.55 ± 23.31 months. The mean operation duration was 59.63 ± 16.89 minutes. All patients experienced satisfactory pain relief defined as a classification of BNI I-IIIb within 3 days after PRFT. The median remission length with satisfactory pain relief was 33 (range, 4-132) months. No serious intraoperative complications, except bradycardia in 6 patients, were recorded. Postprocedure complications, including masticatory muscle weakness, were reported in 5 patients. Although all 38 patients experienced facial dysesthesia, the patients’ Likert scale rating represented that quality of life significantly increased after the procedure. Limitations: The small sample size may have unavoidably caused selection bias in our study. Larger prospective, randomized, multicenter trials are necessary to validate our outcomes. Conclusions: PRFT is an effective and safe treatment that should be considered as an alternative for pain control in the treatment of TRTN. Key words: Pain, secondary trigeminal neuralgia, radiofrequency thermocoagulation, trigeminal neuralgia

Compressive vertebral hemangiomas with neurological deficits: diagnosis, surgical strategies and long term outcome

2021 ◽  
pp. 1-11
Author(s):  
Krishnakumar Kesavapisharady ◽  
Ganesh Divakar ◽  
Tobin George ◽  
Jayadevan E. R. ◽  
Easwer Venkat Hariharan
Keyword(s):  
Neurological Deficits ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Surgical Strategies ◽  
Vertebral Hemangiomas

MICROVASCULAR DECOMPRESSION FOR TRIGEMINAL NEURALGIA IN THE ELDERLY

Neurosurgery ◽  
2009 ◽  
Vol 65 (3) ◽  
pp. 477-482 ◽  
Author(s):  
Thomas Günther ◽  
Venelin M. Gerganov ◽  
Lennart Stieglitz ◽  
Wolf Ludemann ◽  
Amir Samii ◽  
...  
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Microvascular Decompression ◽  
The Elderly ◽  
Safe Procedure ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Younger Patients ◽  
The Mean

Abstract OBJECTIVE Multiple studies have proved that microvascular decompression (MVD) is the treatment of choice in cases of medically refractory trigeminal neuralgia (TN). In the elderly, however, the surgical risks related to MVD are assumed to be unacceptably high and various alternative therapies have been proposed. We evaluated the outcomes of MVD in patients aged older than 65 years of age and compared them with the outcomes in a matched group of younger patients. The focus was on procedure-related morbidity rate and long-term outcome. METHODS This was a retrospective study of 112 patients with TN operated on consecutively over 22 years. The main outcome measures were immediate and long-term postoperative pain relief and neurological status, especially function of trigeminal, facial, and cochlear nerves, as well as surgical complications. A questionnaire was used to assess long-term outcome: pain relief, duration of a pain-free period, need for pain medications, time to recurrence, pain severity, and need for additional treatment. RESULTS The mean age was 70.35 years. The second and third branches of the trigeminal nerve were most frequently affected (37.3%). The mean follow-up period was 90 months (range, 48–295 months). Seventy-five percent of the patients were completely pain free, 11% were never pain free, and 14% experienced recurrences. No statistically significant differences existed in the outcome between the younger and older patient groups. Postoperative morbidity included trigeminal hypesthesia in 6.25%, hypacusis in 5.4%, and complete hearing loss, vertigo, and partial facial nerve palsy in 0.89% each. Cerebrospinal fluid leak and meningitis occurred in 1 patient each. There were no mortalities in both groups. CONCLUSION MVD for TN is a safe procedure even in the elderly. The risk of serious morbidity or mortality is similar to that in younger patients. Furthermore, no significant differences in short- and long-term outcome were found. Thus, MVD is the treatment of choice in patients with medically refractory TN, unless their general condition prohibits it.

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