scholarly journals Long-Term Outcomes of Epidurals with Lidocaine With or Without Steroids for Lumbar Disc Herniation and Spinal Stenosis: A Meta-Analysis

2020 ◽  
Vol 4;23 (7;4) ◽  
pp. 365-373
Author(s):  
Jianxiong An
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Rating Scale ◽  
Lumbar Disc ◽  
Meta Analysis ◽  
Numeric Rating Scale ◽  
Long Term Outcomes ◽  
Effective Pain Relief

Background: Previous meta-analyses examined only the short-term differences between lidocaine and steroids vs lidocaine alone in treating lumbar degenerative diseases. Long-term outcomes (1-2 years) in patients with lumbar disc herniation (LDH) and lumbar central spinal stenosis (LCSS) have not yet been systematically evaluated. Objective: The objective of our study was to assess quantitatively the difference in efficacy at 1 to 2 years between lidocaine alone vs lidocaine and steroids for the management of LDH or LCSS. Study Design: We conducted a meta-analysis. Methods: PubMed, EMBASE, and the Cochrane library were electronically searched up to July 22, 2016, for randomized controlled trials comparing lidocaine alone vs in combination with steroids for the treatment of LDH and LCSS. Effective pain relief (EPR), Numeric Rating Scale (NRS-11), Oswestry Disability Index (ODI), opioid intake (OI), and total employed increased rate (TEIR) were the endpoints. Risk ratios (RRs) or weighted mean difference (WMD) with 95% confidence intervals (CIs) were calculated, and the pooled analysis was conducted using RevMan 5.2. Results: Seven trials were included. EPR was not significantly different at 1 and 2 years, with RR = 1.08 (95% CI, 0.90-1.30; P = .39) and RR = 1.04 (95% CI, 0.92-1.18; P = .51), respectively, in patients treated with lidocaine alone vs in combination with steroids. The NRS11 was also similar at 1 and 2 years. ODI and OI were not significantly different at 1 and 2 years. A similar TEIR effect was also observed for the 2 treatments. Limitations: This meta-analysis relied on a small sample size of trials. Significant heterogeneity among studies was observed. Several significant differences in terms of age of the patients were reported in one included trial. Conclusion: This meta-analysis confirmed the similar effects associated with lidocaine alone vs in combination with steroids for the management of LDH and LCSS. Studies with longer follow-up periods are still recommended. Key words: Effective pain relief, lidocaine, long-term, lumbar central spinal stenosis, lumbar disc herniation, Numeric Rating Scale, opioid intake, Oswestry Disability Index, steroids, total employed increased rate

71. Long-term Outcomes of Standard Discectomy for Lumbar Disc Herniation in Different Age Groups

2007 ◽  
Vol 7 (5) ◽  
pp. 35S
Author(s):  
Etsuro Yorimitsu ◽  
Kazuhiro Chiba ◽  
Yoshiaki Toyama ◽  
Yosio Shinozaki
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Age Groups ◽  
Long Term Outcomes

scholarly journals Surgery versus conservative management for lumbar disc herniation with radiculopathy: A systematic review and meta-analysis

2018 ◽  
Vol 8 (1) ◽  
pp. 42-53 ◽  
Author(s):  
Musa Sani Dan-Azumi ◽  
Bashir Bello ◽  
Salim Ahmad Rufai ◽  
Mamuda Alhaji Abdulrahman
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Conservative Management ◽  
Lumbar Disc ◽  
Meta Analysis ◽  
Term Effect ◽  
Early Surgery ◽  
Short Term ◽  
Conservative Care

Introduction: Lumbar Disk Herniation with Radiculopathy (LDHR) appears to be a large and costly problem. The paradigm regarding the best treatment for LDHR has being between surgery and conservative management. The aim of this study was to compare and summarize evidence regarding the effectiveness of surgery and conservative treatment for individuals with sciatica due to lumbar disc herniation. Methods: This study reviewed all literatures published on individuals with LDHR, who were managed either via surgery or conservative method. Pain and functional disability were the main outcome measures analyzed. A comprehensive search of PubMed, TRIP, PEDro and CINAHL was conducted from October, 2011 to June 2017. Two independent researchers selected the studies, and extracted the data. Methodological quality was assessed using the PEDro scale. Meta-analysis was carried out where suitable. Results: Eight studies involving (n=1,507) were included in the review. Meta-analysis was conducted for only 4 studies (n=784). The meta-analysis showed significant benefit for early surgery than conservative care -8.01(95% CI, -9.27 to -6.72) in the short-term effect -0.49 (95% CI, -0.7 to -0.28). However, the result for long-term effect did not show any significant difference between surgery and conservative care 1.60 (95% CI, -6.85 to 10.05). Conclusion: This current evidence suggest that early surgery for individuals with lumbar disc herniation with radiculopathy is better than conservative care in the short-term without any long-term difference. The results of this review should be interpreted with caution as the populations of the included studies were largely heterogeneous.

scholarly journals Microdiscectomy for the Treatment of Lumbar Disc Herniation: An Evaluation of Reoperations and Long-Term Outcomes

2014 ◽  
Vol 05 (02) ◽  
pp. 077-086 ◽  
Author(s):  
Jerry Du ◽  
Jennifer Shue ◽  
Gisberto Evangelisti ◽  
Andrew Sama ◽  
Alexander Hughes ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Long Term Outcomes

Long-Term Outcomes of Standard Discectomy for Lumbar Disc Herniation

Spine ◽  
2001 ◽  
Vol 26 (6) ◽  
pp. 652-657 ◽  
Author(s):  
Etsuro Yorimitsu ◽  
Kazuhiro Chiba ◽  
Yoshiaki Toyama ◽  
Kiyoshi Hirabayashi
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Long Term Outcomes

scholarly journals Lumbar disc herniation: long-term outcomes after mini-open discectomy

2019 ◽  
Vol 44 (2) ◽  
pp. 407-407 ◽  
Author(s):  
Tianhang Xie ◽  
Xi Yang ◽  
Yueming Song
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Long Term Outcomes ◽  
Mini Open

scholarly journals Lumbar Disc Herniation and Preoperative Modic Changes: A Prospective Analysis of the Clinical Outcomes After Microdiscectomy

2021 ◽  
pp. 219256822097608
Author(s):  
Dinesh Kumarasamy ◽  
Shanmuganathan Rajasekaran ◽  
Sri Vijay Anand K. S ◽  
Dilip Chand Raja Soundararajan ◽  
Ajoy Prasad Shetty T ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Back Pain ◽  
Clinical Outcomes ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Rating Scale ◽  
Lumbar Disc ◽  
Modic Changes ◽  
P Value ◽  
Functional Scores

Study design: Prospective comparative cohort study. Objectives: The study aims to elucidate the relationship between Modic endplate changes and clinical outcomes after a lumbar microdiscectomy. Methods: Consecutive patients undergoing microdiscectomy for lumbar disc herniation (LDH) were prospectively studied. Pre-operative clinical and radiological parameters were recorded. The pain was assessed by Numeric pain rating scale (NPRS), and functional assessment by Oswestry Disability Index (ODI). Minimal clinically important difference (MCID) in outcome was calculated for both the groups. Complications related to surgery were studied. Follow-up was done at 6 weeks, 3 months, 6 months and 1 year. Mac Nab criteria were used to assess patient satisfaction at 1 year. Results: Out of 309 patients, 86 had Modic changes, and 223 had no Modic changes. Both groups had similar back pain (p-value: 0.07) and functional scores (p-value: 0.85) pre-operatively. Postoperatively patients with Modic changes had poorer back pain and ODI scores in the third month, sixth month and 1 year (p-value: 0.001). However, MCID between the groups were not significant (p-value: 0.18 for back pain and 0.58 for ODI scores). Mac Nab criteria at 1 year were worse in Modic patients (p-value: 0.001). No difference was noted among Modic types in the pre-operative and postoperative pain and functional outcomes. Four patients in Modic group (4.7%) and one patient in the non-Modic group (0.5%) developed postoperative discitis (p-value: 0.009). Conclusions: Preoperative Modic changes in lumbar disc herniation is associated with less favorable back pain, functional scores and patient satisfaction in patients undergoing microdiscectomy.

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