Early Outcomes: A Comparison between Biportal Endoscopic Spine Surgery and Open Lumbar Discectomy for Single-Level Lumbar Disc Herniation

2021 ◽  
Vol 104 (1) ◽  
pp. 123-128
Keyword(s):  
Postoperative Pain ◽  
Lumbar Disc Herniation ◽  
Spine Surgery ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Hospital Costs ◽  
Lumbar Discectomy ◽  
Morphine Consumption ◽  
Single Level ◽  
Endoscopic Spine Surgery

Objective: To compare early outcomes between biportal endoscopic spine surgery (BESS) and open lumbar discectomy (OLD) for treating single-level lumbar disc herniation. Materials and Methods: A retrospective cohort study was conducted in 80 cases of single-level lumbar disc herniation that underwent either BESS or OLD. The author compared the perioperative data between BESS and OLD, including operative time (OT), level, side, estimated blood loss (EBL), surgical drain output, hospital stay (HS), hospital costs, visual analogue scale (VAS) scores, morphine consumption, complication, and McNab’s satisfaction outcome. Results: Forty-three patients underwent BESS and 37 underwent OLD. There was 55% female and 45% male. The mean age was 37.8±9.5 years. The BESS group showed significantly (a) lower median morphine consumption than the OLD group (five mg versus nine mg, p<0.001), (b) lower postoperative pain (VAS) at 2-, 4-, 12-, 24-, 48- (p<0.001), and 72-hours post-surgery (p=0.017), and (c) shorter HS (4.8±2.9 days versus 7.4±4.6 days, p=0.003). McNab’s satisfaction outcome of a good or excellent result was comparable between BESS and OLD group (97.7% versus 86.5%, p=0.090). The BESS group, however, had a longer OT than the OLD group (100.4±28.5 versus 67.9±23.2 minutes, p<0.001), and had a higher hospital cost (1,256±360.9 USD versus 910.6±269.8 USD, p<0.001). Complications were not significantly different between the BESS and OLD groups. Conclusion: BESS for single-level lumbar discectomy had less postoperative pain for up to 72 hours, less opioid consumption, and shorter HS, but longer OT and higher hospital costs than OLD. Patient satisfaction outcomes were comparable between the two groups. Keywords: Biportal endoscopic spine surgery, Unilateral biportal endoscopic discectomy, Open lumbar discectomy, Single-level lumbar disc herniation

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

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

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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).<strong></strong></p><p class="abstract"><strong>Results:</strong> 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&lt;0.01). According to modified MacNab's criteria,<strong> </strong>outcome were excellent (81.8%), good (9.09%) and fair<strong> </strong>(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.</p><strong>Conclusions:</strong> 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.

scholarly journals Percutaneous Endoscopic Spine Surgery for Extruded Lumbar Disc Herniation

2018 ◽  
Vol 12 (1) ◽  
pp. 482-495
Author(s):  
Mutombo Menga Arsene ◽  
Xiao-Tao Wu ◽  
Zan- Li Jiang ◽  
Lei Zhu
Keyword(s):  
Minimally Invasive ◽  
Lumbar Disc Herniation ◽  
Spine Surgery ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Surgical Techniques ◽  
Surgical Instruments ◽  
Disc Space ◽  
Advanced Technique ◽  
Endoscopic Spine Surgery

The conventional open discectomy is the gold standard for treating extruded lumbar disc herniation, especially in highly migrated lumbar disc herniation. Endoscopic spine surgery is known to be very challenging and technically demanding, in particular for highly migrated disc herniation. However, several studies have reported numerous effective techniques with results approximatively equal to conventional open surgeries or mini-open surgery. In the last few years, an increased number of endoscopic spine surgical techniques have been proposed in order to overcome various issues encountered in traditional endoscopic spine surgery. Nevertheless, surgical approach selection for treating extruded lumbar disc herniation is based on aspects such as anatomical structures, availability of surgical instruments, surgeon’s experience, and the disc herniation location. Advances in endoscopic visualization and instrumentation, as well as an increased demand for minimally invasive procedures, have led to the popularity of Percutaneous Endoscopic Lumbar Discectomy (PELD). PELD is a recent and advanced technique among other minimally invasive spine surgeries (MIS). It includes various kinds of surgical techniques to treat lumbar disc herniation and aims to offer a safe, less invasive surgical procedure for lumbar disc space decompression and removal of nucleus pulposus.

scholarly journals Isolated Bowel and Bladder Dysfunction following Single Level Lumbar Discectomy : A Rare Observation

2019 ◽  
Vol 9 (1) ◽  
pp. 54-56
Author(s):  
Moududul Haque ◽  
Mohammad Sujan Sharif ◽  
Nowshin Jahan ◽  
Abdullah Al Mahbub ◽  
Rajib Bhattacherjee
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Bladder Dysfunction ◽  
Lumbar Disc ◽  
Cauda Equina ◽  
Lumbar Discectomy ◽  
Leg Pain ◽  
Imaging Studies ◽  
Single Level ◽  
Bowel And Bladder Dysfunction

Cauda equina syndrome is reported as a complication in 0.2% - 1% following lumbar disc herniation . The pathophysiologic mechanism of this complication and its management is yet poorly understood. Though some factors has postulated in different studies. In this case, patient’s back pain and leg pain is satisfactorily improved with newly onset retention of urine followed by overflow incontinence and constipation after a single level lumbar discectomy. No abnormalities were seen on the postoperative imaging studies. This is a retrospective analysis of records and radiographs in a patient who developed acute bowel and bladder dysfunction after surgery for lumbar disc herniation. Bang. J Neurosurgery 2019; 9(1): 54-56

RECURRENT LUMBAR DISC HERNIATION AFTER SINGLE-LEVEL LUMBAR DISCECTOMY

Neurosurgery ◽  
2009 ◽  
Vol 65 (3) ◽  
pp. 574-578 ◽  
Author(s):  
Giannina L. Garcés Ambrossi ◽  
Matthew J. McGirt ◽  
Daniel M. Sciubba ◽  
Timothy F. Witham ◽  
Jean-Paul Wolinsky ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Lumbar Discectomy ◽  
Single Level ◽  
Recurrent Disc Herniation ◽  
Care Costs ◽  
Recurrent Lumbar Disc Herniation

Abstract OBJECTIVE Same-level recurrent lumbar disc herniation complicates outcomes after primary discectomy in a subset of patients. The health care costs associated with the management of this complication are currently unknown. We set out to identify the incidence and health care cost of same-level recurrent disc herniation after single-level lumbar discectomy at our institution. METHODS We retrospectively reviewed 156 consecutive patients undergoing primary single-level lumbar discectomy at one institution. The incidence of symptomatic same-level recurrent disc herniation either responding to conservative therapy or requiring revision discectomy was assessed. Institutional billing and accounting records were reviewed to determine the billing costs of all diagnostic and therapeutic measures used for patients experiencing recurrent disc herniation. RESULTS Twelve months after surgery, 141 patients were available for follow-up. Of these patients, 124 (88%) were symptom free or had minimal symptoms not affecting their daily activity. Radiographically proven symptomatic same-level recurrent disc herniation developed in 17 patients (12%) a median of 8 months after primary discectomy. Eleven patients (7%) required revision surgery, whereas 6 (3.9%) responded to conservative therapy alone. Diagnosis and management of recurrent disc herniation were associated with a mean cost of $26 593 per patient, and the mean cost was markedly less for patients responding to conservative treatment ($2315) compared with those requiring revision surgery ($39 836) (P &lt; 0.001). Of 141 primary lumbar discectomies performed at our institution with the patients followed for 1 year, the total cost associated with the management of subsequent recurrent disc herniation was $452 083 ($289 797 per 100 primary discectomies). CONCLUSION In our experience, recurrent lumbar disc herniation occurred in more than 10% of patients and was associated with substantial health care costs. Development of novel techniques to prevent recurrent lumbar disc herniation is warranted to decrease the health care costs and morbidity associated with this complication. Prolonged conservative management should be attempted when possible to reduce the health care costs of this complication.

scholarly journals Preoperative Design for the Posterolateral Approach in Full-Endoscopic Spine Surgery for the Treatment of L5/S1 Lumbar Disc Herniation

Neurospine ◽  
2019 ◽  
Vol 16 (1) ◽  
pp. 105-112
Author(s):  
Muneyoshi Fujita ◽  
Hirotaka Kawano ◽  
Tomoaki Kitagawa ◽  
Hiroki Iwai ◽  
Yuichi Takano ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Spine Surgery ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Posterolateral Approach ◽  
Endoscopic Spine Surgery

EFFICACY OF ANTIBIOTICS PROPHYLAXIS IN PATIENTS WITH LUMBAR DISC HERNIATION UNDERGOING LUMBAR DISCETOMY

2018 ◽  
Vol 8 (5) ◽  
pp. 14-19
Author(s):  
Tri Truong Van ◽  
Tri Tran Duc Duy ◽  
Khai Vo Le Quang
Keyword(s):  
Surgical Site Infection ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Lumbar Discectomy ◽  
University Hospital ◽  
Site Infection ◽  
Surgical Wound ◽  
A Prospective Study ◽  
Length Of Hospitalization

Introduction: Surgical wound infection in developing coutries is about 3%. Antibiotics prophylaxis may help to reduce the surgical site infection. The objective of this study was to evaluate the efficacy of antibiotics prophylaxis in patients with lumbar disc herniation who were treated with lumbar discectomy at Hue University hospital. Materials and Methods: A prospective study was conducted at Hue University hospital from March 2015 to May 2018 on 54 patients with lumbar disc herniation who were used antibiotics prophylaxis when undergoing discectomy. Results: The infection rate in our study was 0%. Antibiotics prophylaxis reduced the length of hospitalization as well as the medical cost. Conclusion: Antibiotics prophylaxis was effective in preventing surgical site infection despite the fact that the condition of operating rooms did not meet the standard rules. Key words: prophylaxis antibiotics, lumbar disc herniation

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