A 10-Year Follow-Up of the Outcome of Lumbar Microdiscectomy

Findlay, G.; Hall, Brenton; Musa, B S; Oliveira, Maurício da Silva Lorena de; Fear, Simon

doi:10.1097/00007632-199805150-00019

Cited by 168 publications

(95 citation statements)

References 12 publications

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“…These results were consistent with the successful short term results reported on standard lumbar microdiscectomy alone [8,28]. As in other studies of lumbar microdiscectomy, our patients responded to surgery with a large improvement in leg pain and to a lesser, but notable extent in back pain [29].…”

Section: Discussionsupporting

confidence: 92%

An injectable nucleus replacement as an adjunct to microdiscectomy: 2 year follow-up in a pilot clinical study

Berlemann¹,

Schwarzenbach²

2009

Eur Spine J

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Literature indicates that loss of disc tissue from herniation and/or surgery can accelerate degeneration of the disc. The associated loss of disc height may correspond with recurrent back and/or leg pain. A novel hydrogel has been developed to replace lost nucleus pulposus and potentially restore normal disc biomechanics following herniation and surgery. A single-center, non-randomized, prospective feasibility study was undertaken to investigate the use of NuCore Ò Injectable Nucleus hydrogel (Spine Wave, Inc., Shelton, CT, USA) as a replacement for nuclear tissue lost to herniation and microdiscectomy. Fourteen patients were enrolled at the authors' hospital as the initial site in a worldwide multicenter pilot study. Subjects who were entered into the study suffered from radicular pain due to single-level herniated nucleus pulposus and were non-respondent to conservative therapy. Following a standard microdiscectomy procedure, the hydrogel material was injected into the nuclear void to replace what tissue had been lost to the herniation and surgery. Leg and back pain, function and disability scores were monitored pre-and post-operatively through 2 years. Neurologic and physical evaluations, blood and serum analyses, and radiographic evaluations of disc height and implant stability were also performed. Results showed significant improvement for leg and back pain, as well as function scores. No complications or device related adverse events were observed. MR controls confirmed stable position of the implants with no reherniations. Radiographic measurements indicated better maintenance of disc height compared to literature data on microdiscectomy alone. The NuCore Ò material appears to protect the disc from early collapse following microdiscectomy; and therefore, may have the potential to slow the degenerative cascade of the spinal segment over time.

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Section: Discussionsupporting

confidence: 92%

An injectable nucleus replacement as an adjunct to microdiscectomy: 2 year follow-up in a pilot clinical study

Berlemann¹,

Schwarzenbach²

2009

Eur Spine J

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“…l,2 Our return to full activity of 88% compares favorably with other studies. 1,3,4,5,6,7,8,9 That the majority of the athletes in this study returned to competition, after what would appear to be a short hiatus from their physically demanding occupation or avocation, might be ascribed to the relative youth of the patients and their probable high motivation to fully recover and get back to work.…”

Section: (Figures 1aandb)mentioning

confidence: 74%

Microscopic lumbar discectomy results for 60 cases in professional and Olympic athletes

Williams

Watkins

2003

The Spine Journal

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“…Andrews summarized the advantages of the Caspar-type microdiscectomy in comparison with the conventional macrodiscectomy as less need of postoperative analgesics, shorter hospitalisation and faster return to work [1]. The 10-year follow-up after microdiscectomy based on the ''Roland-Morrisscore'' and on the patient satisfaction showed a successrate of ranging from 85 to 91% [3,6]. Microdiscectomy is still the gold standard for open surgical treatment of lumbar disc herniation.…”

Section: Discussionmentioning

confidence: 99%

Lumbar microdiscectomy: subperiosteal versus transmuscular approach and influence on the early postoperative analgesic consumption

2008

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Conventional lumbar microdiscectomy requires subperiosteal dissection of the muscular and tendineous insertions from the midline structures. This prospective, randomized, single center trial aimed to compare a blunt splitting transmuscular approach to the interlaminar window with the subperiosteal microsurgical technique. Two experienced surgeons performed first time lumbar microdiscectomy on 125 patients. The type of approach and retractor used was randomized and both patients and evaluator were blinded to it. In 59 patients a speculumcounter-retractor was inserted through a subperiosteal (SP) route and in 66 patients an expandable tubular retractor was introduced via a transmuscular (TM) approach. In both groups the mean age was 51 years, the male gender prevalent (61%) and the distribution of the operated levels was similar. The outcome measures were VAS for back and leg pain, ODI and the postoperative analgesic consumption was scored by the WHO 3-class protocol. A postsurgical VAS (0-1) was defined as excellent, VAS (2-4) as satisfactory result. In this study the patients scored from 1 to 3 points daily according to the class of drugs taken.Furthermore, a 1/3 point (class 1), 2/3 point (class 2) and 1 point (class 3) was added for each on-demand drug intake. Recovery from radicular pain was excellent (SP 68%, TM 76%) or satisfactory (SP 23%, TM 21%). Recovery from back pain was excellent (SP 58%, TM 59%) or satisfactory (SP 37%, TM 37%). Postoperative mean improvement ODI was: SP 29% and TM 31%. Postoperative mean analgesic intake: SP 4.8 points, TM 2.6 points (P = 0.03). Lumbar microdiscectomy improves pain and ODI irrespective of the type of approach and retractor used. However, the postsurgical analgesic consumption is significantly less if a tubular retractor is inserted via a transmuscular approach.

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A 10-Year Follow-Up of the Outcome of Lumbar Microdiscectomy

Abstract: Lumbar microdiscectomy achieves a high level of initial success, and this positive outcome is maintained at a 10-year follow-up.

Cited by 168 publications

References 12 publications

An injectable nucleus replacement as an adjunct to microdiscectomy: 2 year follow-up in a pilot clinical study

An injectable nucleus replacement as an adjunct to microdiscectomy: 2 year follow-up in a pilot clinical study

Microscopic lumbar discectomy results for 60 cases in professional and Olympic athletes

Lumbar microdiscectomy: subperiosteal versus transmuscular approach and influence on the early postoperative analgesic consumption

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