The Primary Outcome of a Prospective Study: Nucleoplasty with Endoscopic Microdiscectomy (original) (raw)
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BioMed Research International, 2015
Endoscopic disc surgery (EDS) for lumbar spine disc herniation is a well-known but developing field, which is increasingly spreading in the last few years. Rate of recurrence/residual, complications, and outcomes, in comparison with standard microdiscectomy (MD), is still debated and need further data. We performed an extensive review based on the last 6 years of surgical series, systematic reviews, and meta-analyses reported in international, English-written literature. Articles regarding patients treated through endoscopic transforaminal or interlaminar approaches for microdiscectomy (MD) were included in the present review. Papers focused on endoscopic surgery for other spinal diseases were not included. From July 2009 to July 2015, we identified 51 surgical series, 5 systematic reviews, and one meta-analysis reported. In lumbar EDS, rate of complications, length of hospital staying, return to daily activities, and overall patients’ satisfaction seem comparable to standard MD. Ra...
International Journal of Orthopaedics Sciences, 2019
Introduction: Chronic lumbo-sacral pain is a common and challenging clinical entity in pain management centre. The most commonly involved surgical indication are intractable leg or back pain and significant functional impairment that have been unresponsive to conservative measures. This is a level 2 evidence study where we have studied results of endoscopic discectomy and compared it to conventional discectomy procedure. Material and Methods: We selected 40 patients with severe low back pain radiating to one or both lower limbs, which has failed to resolve after prolonged conservative treatment and have less than level 3 disc prolapse. Oswestry Disability Index (For Low Back Pain) was recorded with questionnaire response and used as clinical tool for assessment. Results: Mean age of 40 patients was found to be 42.9 year with 80% patients having paracentral disc protrusion. Average operative time for endoscopic discectomy was 103 minutes which was higher than conventional discectomy (78 minutes). However, there was minimal blood loss compared to conventional discectomy. Based on ODI score, both endoscopic and conventional discectomy offered similar results in all grades. Conclusion: Endoscopic discectomy is a novel, safe and effective method that minimizes invasiveness of the surgical approach. Results achieved with this method are comparable to those achieved with open discectomy in terms of relief of symptoms on longer follow up, and is significantly better in terms of early mobilisation and morbidity as there is minimal tissue trauma.
Lumbar Microdiscectomy: A Clinicoradiological Analysis of Outcome
The Canadian Journal of Neurological Sciences, 2011
Background:The long-term outcome after lumbar microdiscectomy (LMD) may be affected by low back pain (LBP) and segmental instability, the determinants of which remain unclear. We sought to analyze the interaction between clinical, functional, and radiological variables and their impact on patient outcome.Methods:All patients who underwent LMD in 2004-2005 were invited to participate in this retrospective cohort study. Patients were re-evaluated clinically and radiologically after a three to five year follow-up.Results:Forty-one of 97 eligible patients were enrolled. Twelve patients (29.3%) reported moderate-to-severe sciatica, 12 (29.3%) had moderate LBP, and 13 (31.7%) exhibited clinical evidence of segmental instability. Thirty-eight patients (92.7%) had minimal disability and 3 (7.3%) had moderate disability. Twenty-three patients (56.1%) were fully satisfied, while 18 (43.9%) had only partial satisfaction, having expected a better outcome. Thirty-three patients (80.5%) returned ...
Aim: The open micro discectomy is the most widely recognized surgery for the decompression of radiculopathy brought about by lumbar circle herniation. Until this point, an assortment of negligibly obtrusive (MI) strategies have been created. In the most recent many years, endoscopic procedures have been created to perform discectomy. The transformational endoscopic discectomy (TED) with posterolateral access advanced out of the improvement of endoscopic methods. Methods: A precise writing search was performed utilizing the PubMed, EMBASE, and Cochrane Library data sets for preliminaries written in English. Our current research was conducted at Mayo Hospital, Lahore from May 2019 to April 2020. The randomized preliminaries and observational examinations that met our incorporation standards were in this manner included. Two analysts separately extricated information and assessed the danger of inclination. All measurable investigations were performed utilizing Review Manager 5.3. Results: Five planned and four review examines including 1529 patients were incorporated. The consequences of the meta-investigation demonstrated that there were critical contrasts between the two gatherings long of medical clinic stay (MD = − 9.42, 96% CI − 10.27, − 8.57; p esteem < 0.00002). Nonetheless, there were no huge contrasts in the leg visual simple scale (VAS) scores, the Oswestry Disability Index (ODI) scores, and the frequency of complexities and repeat. Conclusion: The transformational endoscopic discectomy is better than open micro discectomy in the length of clinic stay. Be that as it may, there were no distinctions in leg torment, practical recuperation, and rate of difficulties among TED and MD in treating LDH.
International Journal of Spine Surgery
Purpose: The objective was to compare the traditional microdiscectomy with percutaneous endoscopic lumbar discectomy for the treatment of disc herniations regarding pain, disability, and complications. Methods: Randomized clinical trial with 47 patients with disc herniations treated with 2 different surgical techniques: traditional microdiscectomy or percutaneous endoscopic lumbar discectomy. Forty-seven patients were divided into 2 groups and monitored for 12 months. Irradiated and low back pain were evaluated with the visual analog scale. Surgery complications were recorded. Results: After surgery, the sciatica and disability improved significantly but without significant differences between the groups. Improvements in back pain were significant until the third month. There were no statistical differences between groups regarding recurrence, infection, and the need for reoperation. Conclusions: Endoscopic discectomy results are similar to those of conventional microdiscectomy regarding pain and disability improvement. Postoperative lumbar pain is less intense with endoscopic discectomy than conventional microdiscectomy only during the first 3 months. Endoscopic discectomy is a safe and efficient alternative to microdiscectomy. Clinical Trials: Trial protocol registration number: RBR-5symrd (http://www.ensaiosclinicos.gov.br).
Chinese medical journal, 2015
This study evaluated the efficacy of percutaneous nucleoplasty using coblation technique for the treatment of chronic nonspecific low back pain (LBP), after 5 years of follow-up. From September 2004 to November 2006, 172 patients underwent percutaneous nucleoplasty for chronic LBP in our department. Forty-one of these patients were followed up for a mean period of 67 months. Nucleoplasty was performed at L3/4 in 1 patient; L4/5 in 25 patients; L5/S1 in 2 patients; L3/4 and L4/5 in 2 patients; L4/5 and L5/S1 in 7 patients; and L3/4, L4/5, and L5/S1 in 4 patients. Patients were assessed preoperatively and at 1 week, 1 year, 3 years, and 5 years postoperatively. Pain was graded using a 10-cm Visual Analogue Scale (VAS) and the percentage reduction in pain score was calculated at each postoperative time point. The Oswestry Disability Index (ODI) was used to assess disability-related to lumbar spine degeneration, and patient satisfaction was assessed using the modified MacNab criteria. T...
Evaluation of nucleoplasty in patients of low back pain with radiculopathy: A preliminary report
Introduction: Low back pain (LBP) has a point prevalence of 11.9 ± 2% worldwide. Nucleoplasty is a minimally invasive procedure, combining disc removal and thermal coagulation using radiofrequency waves in the nucleus pulposus. The purpose of this preliminary study was to evaluate the efficacy of nucleoplasty in patients with low back pain and radiculopathy, and to have comparative evaluation of the disc appearance on MRI pre-and post-procedure.
Journal of Advances in Medicine and Medical Research
Aims: To compare the results obtained from a cohort of patients with posterolateral lumbar disc prolapse regarding the postoperative improvement of back pain and radicular pain, in patients operated for endoscopic lumbar discectomy, with a group of patients operated for microscopic lumbar discectomy, in the Neurosurgery Department, Tanta University Hospitals, from November 2021 till the end of October 2022. Methodology: A prospective analysis was performed on 40 patients operated for minimally invasive lumbar discectomy, 20 patients underwent microscopic discectomy and 20 patients underwent endoscopic discectomy. This randomized clinical trial took place in the Neurosurgery department, Tanta University Hospitals in Egypt. Results: 40 patients with posterolateral single level de novo lumbar disc herniations were included. 20 patients underwent microscopic discectomy, and 20 patients underwent endoscopic discectomy. Both groups exhibited significant improvements in radicular and back ...