Limited Discectomy for single level lumbar disc herniation: a retrospective study in a tertiary level hospital

Objective: To perform retrospective analysis of 1000 patients who underwent open limited discectomy (OLD) for single level lumbar disc herniation (LDH) and to assess the long- term clinical outcomes. Methods: 745 men and 255 women, with mean age of 38.03 ± 9.14 years (range 19- 55 years) who had primary LDH at L4-5 (n=640), L5-S1 (n=352), and L3-4 (n=8); underwent OLD were reviewed. Records were obtained regarding their demographic data, the side and level of disc herniation, operating time period, intraoperative blood loss, hospital stay, and perioperative complications. VAS score was measured before and after operation, for the assessment of low back pain (LBP) and radicular pain. Comprehensive outcome outcomes were measured postoperatively with the modified Macnab criteria and the Oswestry Disability Index (ODI) score. Results: The mean follows up was 24.5 (range 24-70) months. Significant improvement of mean VAS score for back and leg pain was achieved. At the two years follow-up, results were excellent in 525 (52.50%), good in 325 (32.50%), fair in 140 (14.00%) and poor in 10 (1.00%). Complications found were reherniation (n=52), discitis (n=19), superficial wound infection (n=7), dural tear (n=7) and foot drop (n=2). Conclusion: Open limited discectomy following fenestration or laminotomy is a safe and effective procedure and achieved favorable long-term outcome (e.g., low rate of recurrent LBP) and excellent patients’ satisfaction. Bangladesh Journal of Medical Science Vol. 21(1) 2022 Page : 37-44

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Long-Term Outcome of Patients who Underwent Percutaneous Nucleotomy for Lumbar Disc Herniation: Results after a Mean Follow-up of 5 Years

Acta Neurochirurgica ◽

10.1007/s007010050070 ◽

1998 ◽

Vol 140 (2) ◽

pp. 108-113 ◽

Cited By ~ 16

Author(s):

E. Kotilainen ◽

S. Valtonen

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Term Outcome ◽

Long Term Outcome

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

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20174703 ◽

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

Background: 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.Methods: 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).Results: 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<0.01). According to modified MacNab's criteria, outcome were excellent (81.8%), good (9.09%) and fair (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.Conclusions: 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.

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Long-Term Outcome of Patients Suffering from Clinical Instability after Microsurgical Treatment of Lumbar Disc Herniation

Acta Neurochirurgica ◽

10.1007/s007010050072 ◽

1998 ◽

Vol 140 (2) ◽

pp. 120-125 ◽

Cited By ~ 24

Author(s):

E. Kotilainen

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Term Outcome ◽

Long Term Outcome ◽

Microsurgical Treatment ◽

Clinical Instability

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Clinical Outcome of Full-endoscopic Interlaminar Discectomy for Single-level Lumbar Disc Herniation: A Minimum of 5-year Follow-up

January 2018 - Pain Physician ◽

10.36076/ppj.2017.e430 ◽

2017 ◽

Vol 3 (20;3) ◽

pp. E425-E430 ◽

Cited By ~ 1

Author(s):

Bing Wang

Keyword(s):

Retrospective Study ◽

Clinical Outcome ◽

Hospital Stay ◽

Clinical Outcomes ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Single Level

Background: Full-endoscopic interlaminar discectomy (FEID) is widely applied for the treatment of lumbar disc herniation (LDH) and satisfactory short-term outcomes have been achieved. However, the long-term evaluation for this technique is still lacking, especially the comparison between FEID and microendoscopic discectomy (MED). Objective: To evaluate the clinical outcome of FEID technique in comparison with MED for singlelevel LDH with a minimum of 5-year follow-up. Study Design: Retrospective study. Setting: Inpatient surgery center. Methods: A total of 152 patients with single-level LDH located at either L4-L5 or L5-S1 who underwent either FEID or MED from August 2008 to April 2011 at our hospital were enrolled in this study. General parameters including operative time, length of hospital stay, mean time to return to work, complications, and recurrences were recorded. Clinical outcomes were evaluated using visual analog scale (VAS) for low back and leg pain, Oswestry Disability Index (ODI) for functional assessment, and modified MacNab criteria for patient satisfaction. Results: At the final follow-up, the VAS of leg and back pain decreased from 7.6 ± 1.6 and 3.1 ± 2.2 points preoperatively to 1.6 ± 1.2 and 1.7 ± 0.9 at the final follow-up, respectively (P < 0.05). The ODI score was 69.5% ± 10.5% preoperatively, and declined to 21.8% ± 7.0% at the final follow-up (P < 0.05). VAS, ODI, and modified MacNab criteria of the FEID group were improved compared to the control group though there were no statistically significant differences between the 2 groups. Limitations: This was a retrospective study with a relatively small sample size. Additionally, this study contained only clinical outcomes, without long-term radiological outcomes. Conclusions: The application of FEID achieved similar satisfactory long-term clinical outcomes for the surgical treatment of LDH as MED. However, compared with MED, FEID exhibits advantages including less operation time, shorter hospital stay, and faster postoperative recovery. Key words: Lumbar disc herniation, full-endoscopic interlaminar discectomy, microendoscopic disectomy, long-term Pain Physician 2017

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