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D Shrestha, R Shrestha, D Dhoju, S Kayastha, S C Jha
Background Outcome of lumbar disc herniation are influenced by various clinical, socioeconomic and psychological factors. In the absence of provision of medical insurances, worker's compensation and sick leave, predictors for outcome after lumbar disc herniation surgery will be different in Nepalese population. Objective To evaluate different clinical variables that can affect outcome after lumbar disc herniation surgery. Method Among 88 patients who underwent microdisectomy for lumbar disc herniation, 63 patients (43 male, 20 female) with follow up at least six months were retrospectively evaluated for clinical variables which can affect Oswestry disability index (ODI) score, its interpretation and Mcnab classification of post operative outcome...
October 2015: Kathmandu University Medical Journal (KUMJ)
Neil Badlani, Elizabeth Yu, Junyoung Ahn, Mark F Kurd, Safdar N Khan
Herniated disks in the lumbar spine typically present with the sudden onset of back and leg pain in a myodermatomal distribution. Symptoms may include radicular pain, paresthesias, and in extreme cases weakness or foot drop. Typically patients are treated conservatively for 6-8 weeks with a combination of steroids, nonsteroidal anti-inflammatory drugs, physical therapy, epidural steroid injections, and rest. In the absence of symptom improvement, surgical intervention typically with a microdisectomy is recommended to patients who are refractory to at least 6 weeks of nonoperative treatment...
April 2016: Clinical Spine Surgery
Samie A Dogar, Fauzia A Khan
BACKGROUND: The tramadol and paracetamol combination is used frequently for postoperative pain management. The literature on the use of this combination for vertebral surgery is limited. Our objective was to compare a combination of paracetamol 1 g and a lower dose of tramadol (1 mg/kg: group 1T) with a combination of paracetamol 1 g and a higher dose of tramadol (1.5 mg/kg: group 1.5T) for postoperative pain after microdisectomy surgery. Our main outcome measure was Visual Analogue Scale pain scores for 4 hours postoperatively...
January 19, 2016: Journal of Neurosurgical Anesthesiology
Chatupon Chotigavanichaya, Ekkapoj Korwutthikulrangsri, Sumeth Suratkarndawadee, Monchai Ruangchainikom, Thanet Watthanaapisith, Surin Tanapipatsiri, Areesak Chotivichit
BACKGROUND: Herniated nucleus pulposus (HNP) is a common cause of low back pain. The conventional technique could injure to the surrounding structures. The tubular retractor system (METRx-X tube, Medtronic, Inc, Minneapolis, USA) is instrument to improve visualization and limited soft tissue damage for minimal invasive lumbar discetomy. OBJECTIVE: To evaluate the surgical outcomes, complications, reoperation rates and patient satisfaction for using tubular retractor system in lumbar disectomy in long term follow-up at least 4 years...
September 2012: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Jin-Sung Kim, Hyeong Seok Oh, Sang-Ho Lee
OBJECTIVE: During revision microdiscectomy for recurrent lumbar disc herniation (rLDH), the major concerns are approach-related complications, including dural tear and nerve root injury, because of adhesion scars and granulation tissue along the previous laminotomy site. In revision microdiscectomy of rLDH, carbon dioxide (CO2) laser can enable precise dissection and removal of adhesion scar. The purpose of this study was to evaluate the clinical usefulness of CO2 laser dissection in patients who had undergone revision microdisectomy of rLDH...
October 2012: Photomedicine and Laser Surgery
Jo Jordan, Kika Konstantinou, John O'Dowd
INTRODUCTION: Herniated lumbar disc is a displacement of disc material (nucleus pulposus or annulus fibrosis) beyond the intervertebral disc space. The highest prevalence is among people aged 30-50 years, with a male to female ratio of 2:1. There is little evidence to suggest that drug treatments are effective in treating herniated disc. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of drug treatments, non-drug treatments, and surgery for herniated lumbar disc? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2008 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review)...
2009: Clinical Evidence
W J Wang, J N Zhou, J M Yu
OBJECTIVE: To study the indications and efficacy of percutaneous cervical arthroscopic microdiscectomy (PCAD). METHODS: Twenty eight patients with cervical discs herniation or disorders received endoscopic spine surgery, 37 intervertebral cervical discs underwent partial nuclectomy or total nucleotomy; the efficacy and complication were evaluated in three months after operation. RELUT: Good/excellent results were obtained in 23/28(82.2%) cases according to MacNab criteria; no serious complication was found; the cervical stability did not decrease in most cases...
August 28, 2001: Hunan Yi Ke da Xue Xue Bao, Hunan Yike Daxue Xuebao, Bulletin of Hunan Medical University
Der-Yang Cho, Wen-Rei Liau, Wen-Yen Lee, Jung-Tung Liu, Chung-Lian Chiu, Pon-Chun Sheu
OBJECTIVE: We investigated the effectiveness of a new material, polyetheretherketone (PEEK), in a spinal cage used in performing cervical spinal fusion for the correction of cervical kyphosis. METHODS: A total of 80 patients with various cervical diseases were divided into two groups. Patients in Group A (40 patients) underwent microdiscectomy and PEEK cage fusion, and patients in Group B (40 patients) were treated with microdisectomy and autogenous iliac crest graft (AICG) fusion...
December 2002: Neurosurgery
F Porchet
Low back pain alone without any sciatica is not an appropriate indication for lumbar disc surgery. The only exception might be a clinically and radiologically proven segmental instability. However a conservative multidisciplinary treatment should precede surgery. Good and excellent results of lumbar disc surgery are achieved in 80-90% of cases. The appropriate surgical indication and the postoperative reeducation are of utmost importance for good results. The patients history, neurological examination, neuroradiological imaging and failed conservative treatment modalities are key elements to define appropriate surgical candidates...
October 25, 2001: Praxis
F Aldrich
The controversy over whether to use a posterior or anterior approach for surgical treatment of soft cervical discs is still largely unsettled. However, although the posterior approach may be underutilized, it has distinct advantages when there are specific indications. Out of a large pool of cases, 53 patients presented with acute monoradiculopathy caused by soft cervical disc herniation. In 36 of these, the disc was sequestered (nonconfined) and was posterolateral to the disc space as seen on computerized tomography-myelography...
March 1990: Journal of Neurosurgery
W Caspar, B Campbell, D D Barbier, R Kretschmmer, Y Gotfried
The outcome in 119 patients who were operated on with a conventional standard lumbar discectomy procedure was retrospectively compared with that in 299 patients who were operated on with a microsurgical discectomy technique developed in Homburg/Saar, Federal Republic of Germany by the senior author (W.C.). All patients in this consecutive series had "virgin" lumbar radiculopathy evaluated and operated upon by two experienced surgeons at one institution. Determination of the final outcome was made objectively by an impartial third party using identical criteria for both groups, and with a patient self-evaluation form...
January 1991: Neurosurgery
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