scholarly journals Postoperative Clinical Outcome and Risk Factors for Poor Outcome of Foraminal and Extraforaminal Lumbar Disc Herniation

2016 ◽  
Vol 59 (2) ◽  
pp. 143 ◽  
Author(s):  
Jung Sik Bae ◽  
Kyung Hee Kang ◽  
Jeong Hyun Park ◽  
Jae Hyeon Lim ◽  
Il Tae Jang
Keyword(s):  
Risk Factors ◽  
Clinical Outcome ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Poor Outcome

Risk factors for recurrent lumbar disc herniation after discectomy

2018 ◽  
Vol 43 (4) ◽  
pp. 963-967 ◽  
Author(s):  
Eun-Ho Shin ◽  
Kyu-Jung Cho ◽  
Young-Tae Kim ◽  
Myung-Hoon Park
Keyword(s):  
Risk Factors ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Recurrent Lumbar Disc Herniation

scholarly journals Minimally invasive tubular microdiscectomy for recurrent lumbar disc herniation

2016 ◽  
Vol 24 (1) ◽  
pp. 48-53 ◽  
Author(s):  
Ulrich Hubbe ◽  
Pamela Franco-Jimenez ◽  
Jan-Helge Klingler ◽  
Ioannis Vasilikos ◽  
Christoph Scholz ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Minimally Invasive ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Operating Time ◽  
Leg Pain ◽  
P Value ◽  
Vas Scores ◽  
Recurrent Lumbar Disc Herniation

OBJECT The aim of the study was to investigate the safety and efficacy of minimally invasive tubular microdiscectomy for the treatment of recurrent lumbar disc herniation (LDH). As opposed to endoscopic techniques, namely microendoscopic and endoscopic transforaminal discectomy, this microscopically assisted technique has never been used for the treatment of recurrent LDH. METHODS Thirty consecutive patients who underwent minimally invasive tubular microdiscectomy for recurrent LDH were included in the study. The preoperative and postoperative visual analog scale (VAS) scores for pain, the clinical outcome according to modified Macnab criteria, and complications were analyzed retrospectively. The minimum follow-up was 1.5 years. Student t-test with paired samples was used for the statistical comparison of pre- and postoperative VAS scores. A p value < 0.05 was considered to be statistically significant. RESULTS The mean operating time was 90 ± 35 minutes. The VAS score for leg pain was significantly reduced from 5.9 ± 2.1 preoperatively to 1.7 ± 1.3 postoperatively (p < 0.001). The overall success rate (excellent or good outcome according to Macnab criteria) was 90%. Incidental durotomy occurred in 5 patients (16.7%) without neurological consequences, CSF fistula, or negative influence to the clinical outcome. Instability occurred in 2 patients (6.7%). CONCLUSIONS The clinical outcome of minimally invasive tubular microdiscectomy is comparable to the reported success rates of other minimally invasive techniques. The dural tear rate is not associated to higher morbidity or worse outcome. The technique is an equally effective and safe treatment option for recurrent LDH.

scholarly journals Preoperative retrolisthesis as a risk factor of postdecompression lumbar disc herniation

2016 ◽  
Vol 24 (4) ◽  
pp. 592-601 ◽  
Author(s):  
Shota Takenaka ◽  
Kosuke Tateishi ◽  
Noboru Hosono ◽  
Yoshihiro Mukai ◽  
Takeshi Fuji
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Area Under The Curve ◽  
Lumbar Spinal ◽  
Acute Sciatica

OBJECT In this study, the authors aimed to identify specific risk factors for postdecompression lumbar disc herniation (PDLDH) in patients who have not undergone discectomy and/or fusion. METHODS Between 2007 and 2012, 493 patients with lumbar spinal stenosis underwent bilateral partial laminectomy without discectomy and/or fusion in a single hospital. Eighteen patients (herniation group [H group]: 15 men, 3 women; mean age 65.1 years) developed acute sciatica as a result of PDLDH within 2 years after surgery. Ninety patients who did not develop postoperative acute sciatica were selected as a control group (C group: 75 men, 15 women; mean age 65.4 years). Patients in the C group were age and sex matched with those in the H group. The patients in the groups were also matched for decompression level, number of decompression levels, and surgery date. The radiographic variables measured included percentage of slippage, intervertebral angle, range of motion, lumbar lordosis, disc height, facet angle, extent of facet removal, facet degeneration, disc degeneration, and vertebral endplate degeneration. The threshold for PDLDH risk factors was evaluated using a continuous numerical variable and receiver operating characteristic curve analysis. The area under the curve was used to determine the diagnostic performance, and values greater than 0.75 were considered to represent good performance. RESULTS Multivariate analysis revealed that preoperative retrolisthesis during extension was the sole significant independent risk factor for PDLDH. The area under the curve for preoperative retrolisthesis during extension was 0.849; the cutoff value was estimated to be a retrolisthesis of 7.2% during extension. CONCLUSIONS The authors observed that bilateral partial laminectomy, performed along with the removal of the posterior support ligament, may not be suitable for lumbar spinal stenosis patients with preoperative retrolisthesis greater than 7.2% during extension.

scholarly journals Learning curve of trans-sacral epiduroscopic laser decompression in herniated lumbar disc disease

2020 ◽  
Author(s):  
Seong Son ◽  
Chan Jong Yoo ◽  
Byung Rhae Yoo ◽  
Woo Seok Kim ◽  
Tae Seok Jeong
Keyword(s):  
Clinical Outcome ◽  
Minimally Invasive ◽  
Learning Curve ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Operation Time ◽  
Early Group ◽  
Significant Difference ◽  
Late Group

Abstract Background: Trans-sacral epiduroscopic laser decompression (SELD) using slender epiduroscope and a holmium YAG laser is one of the minimally invasive surgical options for lumbar disc herniation. However, the learning curve of SELD and the effect of surgical proficiency on clinical outcome have not yet been established. We investigated patients with lumbar disc herniation undergoing SELD to report the clinical outcome and learning curve. Methods: Retrospective analysis of clinical outcome and learning curve were performed at a single center from clinical data collected from November 2015 to November 2018. A total of 82 patients who underwent single-level SELD for lumbar disc herniation with a minimum follow-up of 6.0 months were enrolled. Based on the findings that the cut-off of familiarity was 20 cases according to the cumulative study of operation time, patients were allocated to two groups: early group (n = 20) and late group (n = 62). The surgical, clinical, and radiological outcomes were retrospectively evaluated between the two groups to analyze the learning curve of SELD.Results: According to linear and log regression analyses, the operation time was obtained by the formula: operation time = 58.825 - (0.181 × [case number]) (p < 0.001). The mean operation time was significantly different between the two groups (mean 56.95 minutes; 95% confidence interval [CI], 49.12–64.78 in the early group versus mean 45.34 minutes; 95% CI, 42.45–48.22 in the late group; p = 0.008, non-parametric Mann-Whitney U test).Baseline characteristics, including demographic data, clinical factors, and findings of preoperative magnetic resonance imaging, did not differ between the two groups. Also, there was no significant difference in terms of surgical outcomes, including complication and failure rates, as well as clinical and radiological outcomes between the two groups.Conclusion: The learning curve of SELD was not as steep as that of other minimally invasive spinal surgery techniques, and the experience of surgery was not an influencing factor for outcome variation.

scholarly journals Learning curve of trans-sacral epiduroscopic laser decompression in herniated lumbar disc disease

2020 ◽  
Author(s):  
Seong Son ◽  
Chan Jong Yoo ◽  
Byung Rhae Yoo ◽  
Woo Seok Kim ◽  
Tae Seok Jeong
Keyword(s):  
Clinical Outcome ◽  
Minimally Invasive ◽  
Learning Curve ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Operation Time ◽  
Early Group ◽  
Significant Difference ◽  
Late Group

Abstract Background: Trans-sacral epiduroscopic laser decompression (SELD) using slender epiduroscope and a holmium YAG laser is one of the minimally invasive surgical options for lumbar disc herniation.However, the learning curve of SELD and the effect of surgical proficiency on clinical outcome have not yet been established. We investigated patients with lumbar disc herniation undergoing SELD to report the clinical outcome and learning curve.Methods: Retrospective analysis of clinical outcome and learning curve were performed at a single center from clinical data collected from November 2015 to November 2018. A total of 82 patients who underwent single-level SELD for lumbar disc herniation with a minimum follow-up of 6.0 months were enrolled. Based on the findings that the cut-off of familiarity was 20 cases according to the cumulative study of operation time, patients were allocated to two groups: early group (n = 20) and late group (n = 62). The surgical, clinical, and radiological outcomes were retrospectively evaluated between the two groups to analyze the learning curve of SELD.Results: According to linear and log regression analyses, the operation time was obtained by the formula: operation time = 58.825 - (0.181 × [case number]) (p < 0.001). The mean operation time was significantly different between the two groups (mean 56.95 minutes; 95% confidence interval [CI], 49.12–64.78 in the early group versus mean 45.34 minutes; 95% CI, 42.45–48.22 in the late group; p = 0.008, non-parametric Mann-Whitney U test).Baseline characteristics, including demographic data, clinical factors, and findings of preoperative magnetic resonance imaging, did not differ between the two groups. Also, there was no significant difference in terms of surgical outcomes, including complication and failure rates, as well as clinical and radiological outcomes between the two groups.Conclusion: The learning curve of SELD was not as steep as that of other minimally invasive spinal surgery techniques, and the experience of surgery was not an influencing factor for outcome variation.

scholarly journals Recurrent Lumbar Disc Herniation: A Review

2017 ◽  
Vol 9 (2) ◽  
pp. 202-209 ◽  
Author(s):  
Nicholas Shepard ◽  
Woojin Cho
Keyword(s):  
Risk Factors ◽  
Surgical Management ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Cochrane Library ◽  
Disc Disease ◽  
Disc Herniations ◽  
Invasive Techniques ◽  
Recurrent Lumbar Disc Herniation

Study Design: Narrative review. Objectives: To identify the risk factors and surgical management for recurrent lumbar disc herniation using a systematic review of available evidence. Methods: We conducted a review of PubMed, MEDLINE, OVID, and Cochrane Library databases using search terms identifying recurrent lumbar disc herniation and risk factors or surgical management. Abstracts of all identified articles were reviewed. Detailed information from articles with levels I to IV evidence was extracted and synthesized. Results: There is intermediate levels III to IV evidence detailing perioperative risk factors and the optimal surgical technique for recurrent lumbar disc herniations. Conclusions: Multiple risk factors including smoking, diabetes mellitus, obesity, intraoperative technique, and biomechanical factors may contribute to the development of recurrent disc disease. There is widespread variation regarding optimal surgical management for recurrent herniation, which often include revision discectomies with or without fusion via open and minimally invasive techniques.

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