Comparing results of Endoscopic microdiscectomy and conventional discectomy for lumbar disc disease: A short term study

Vora, Padmanabh; Thaker, Parth; Gandhi, Jeet; Gupta, Yash; Panchal, Himanshu; Prabhakar, Mukund M

doi:10.22271/ortho.2019.v5.i1a.06

Cited by 3 publications

(1 citation statement)

References 9 publications

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“…In addition, Dvorak et al [20] report that 70% of patients suffered low back pain during long-term follow-up after open lumbar discectomy. Vora et al [21] reported that average operative time for endoscopic discectomy was higher than conventional discectomy. However, there was minimal blood loss compared to conventional discectomy.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic versus conventional discectomy in lumbar disc prolapse

Ramesh¹,

John²,

Jothi³

2020

Int. J. Orthop. Sci.

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Background: Discectomy is an accepted surgical treatment with better outcome, in the management of disc prolapsed. This discectomy is being done conventionally for several decades whereas endoscopic microdiscectomy is slowly picking up and more frequently being done in the past two decades. Though there were several advantage and disadvantages prevails among both procedures, the outcome remains controversy and thus this study was conducted. Methods: This study was done as a Prospective Randomized comparative study, among patients undergoing lumbar discectomy in the department of orthopedics at Sri Muthukumaran Medical College and Research Institute during January 2019 to January 2020. A total of 60 cases with disc prolapsed were included in the study. Thirty patients were randomized to each conventionl and endoscopic discectomy group. Oswestry Disability Index (ODI-for Low Back Pain) and VAS score (10 point scale) were used as clinical tool for assessment. Data analysis was done using Statistical Package for Social Sciences, version 20. Results: Significant higher duration of surgery, was reported in endoscopic discectomy compared to conventional discectomy whereas mean post operative pain score (VAS) and mean duration of hospital stay were significantly higher among the conventional group. Though ODI scores were high among the conventional group, it was not significant. Conclusion: Endoscopic discectomy is a novel, safe and effective method that minimizes invasiveness of the surgical approach.

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Section: Discussionmentioning

confidence: 99%

Endoscopic versus conventional discectomy in lumbar disc prolapse

Ramesh¹,

John²,

Jothi³

2020

Int. J. Orthop. Sci.

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Caudal epidural blockades for chronic pain in the lower back in working age

I.I.

Lokhovinin²,

V.V.

2022

Medicinskij sovet

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Introduction. Chronic back pain syndrome, which significantly restricts a person’s daily activity, can cause the formation of depressive states and is a significantly more difficult task for treatment compared to acute pain.Aim. To evaluate the efficacy and safety of caudal epidural catheterization (CEC) and local therapy with anesthetics and glucocorticoids for chronic nonspecific discogenic and chronic radicular low back pain (LBP) in young and middle-aged patients.Materials and methods. 42 patients aged from 29 to 59 years, who in the neurosurgical department of the Vologda City Hospital No. 1 in 2017–2019 underwent an operation to install a caudal epidural catheter and prolonged injection therapy of local anesthetics and glucocorticosteroids for chronic nonspecific discogenic and chronic radicular LBP.Results. There were no purulent-septic complications, hematomas of the spinal canal. In the group of patients with radicular syndrome the average values of LBP according to VAS were as follows: before CEC – 78.5 mm; 5 days after CEC – 24.1 mm; 6 months after CEC – 19.6 mm; after 12 months – 17.9 mm. In the group of patients with nonspecific discogenic LBP the average pain estimates for VAS were as follows: before CEC – 78.1 mm; 5 days after CEC – 21.7 mm; 6 months after CEC – 20.9 mm; after 12 months – 23.4 mm.Сonclusion. Our experience indicates a high long-term efficacy and safety of treatment with caudal epidural catheterization and local prolonged therapy with anesthetics and glucocorticoids for chronic radicular and chronic nonspecific discogenic pain in the lower back in young and middle-aged patients selected on the basis of a special system of criteria.

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A Clinical Study on Functional Outcome of Percutaneous Transforaminal Endoscopic Discectomy under Local Anesthesia

Nema,

Agarwal

2023

Journal of Orthopedics, Traumatology and Rehabilitation

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Background: Many surgical approaches from conventional open discectomy, microdiscectomy, percutaneous endoscopic interlaminar discectomy, and transforaminal endoscopic discectomy have been used for the treatment of prolapsed intervertebral disc. Transforaminal endoscopic discectomy through a Kambin’s triangle is a minimally invasive procedure which can be done under local anesthesia, without muscle splitting, with short hospital stay and minimal complications compared to other techniques used. Aim: The aim of this study was to evaluate the functional outcomes following percutaneous transforaminal endoscopic discectomy (PTED) under local anesthesia for lumbar disc herniations. Materials and Methods: This interventional study was conducted between November 2020 and October 2021 in our Orthopaedics Department after the clearance of the Ethical Committee. This study included 54 patients with radicular pain for at least 3 weeks with a positive nerve root compression sign and who underwent PTED under local anesthesia. The Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI) have been used for pre- and postoperative clinical assessment of the patients, and follow-up was done at 6 weeks, 3 months, 6 months, and 1 year postoperatively. Results: Maximum patients were in the age group of 61–70 years, and 65.2% of the patients were male. 68.2% of patients had lumbar disc herniation at L4-L5 level. The mean operative time of PTED was 70.6 min. Out of 16 cases of L5-S1 disc prolapse, 1 case was operated by making an iliac bone window due to the inaccessibility of disc space because of highly placed iliac crest. The mean preoperative VAS and ODI scores were 8.1 and 56.6, respectively. The postoperative VAS and ODI scores were dramatically improved at each follow-up interval (P < 0.0001). Out of 66 patients who underwent operation, 4 patients developed surgical site infection and 2 were found to have dysesthesia, and no serious complications were noted. Conclusion: PTED has been shown to be a safe, effective, and minimally invasive alternative for the treatment of lumbar disc herniation. PTED found to be favorable because it had a shorter operational time and less epidural scarring, allowing for simple revision procedures as needed. As a result, this points to a greater acceptability of endoscopic procedures and their possible widespread use in the future.

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Comparing results of Endoscopic microdiscectomy and conventional discectomy for lumbar disc disease: A short term study

Cited by 3 publications

References 9 publications

Endoscopic versus conventional discectomy in lumbar disc prolapse

Endoscopic versus conventional discectomy in lumbar disc prolapse

Caudal epidural blockades for chronic pain in the lower back in working age

A Clinical Study on Functional Outcome of Percutaneous Transforaminal Endoscopic Discectomy under Local Anesthesia

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