Fitness for work after surgery for lumbar disc herniation: a retrospective study

Donceel, Peter; Bois, Marc Du

doi:10.1007/s005860050023

Cited by 58 publications

(40 citation statements)

References 15 publications

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“…Generally, microscopic discectomy after laminotomy is still considered the gold standard 2,3,7,14,19) , but recently numerous studies involving endoscopic discectomy have been reported, and the outcomes have been improving gradually 1,2,10,[13][14][15][16][17][20][21][22]29) . However, the lateral approach endoscopic discectomy has many limitations due to anatomic barriers, such as the iliac wing.…”

Section: Discussionmentioning

confidence: 99%

Strategies for Noncontained Lumbar Disc Herniation by an Endoscopic Approach : Transforaminal Suprapedicular Approach, Semi-Rigid Flexible Curved Probe, and 3-Dimensional Reconstruction CT with Discogram

Chae

Lee

et al. 2009

J Korean Neurosurg Soc

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Objective : The purpose of this study was to evaluate the efficacy of a transforaminal suprapedicular approach, semi-rigid flexible curved probe, and 3-dimensional reconstruction computed tomography (3D-CT) with discogram in the endoscopic treatment of non-contained lumbar disc herniations. Methods : The subjects were 153 patients with difficult, non-contained lumbar disc herniations undergoing endoscopic treatment. The types of herniation were as follows : extraforaminal, 17 patients; foraminal, 21 patients; high grade migration, 59 patients; and high canal compromise, 56 patients. To overcome the difficulties in endoscopic treatment, the anatomic structures were analyzed by 3D reconstruction CT and the high grade disc was extracted using a semi-rigid flexible curved probe and a transforaminal suprapedicular approach. Results : The mean follow-up was 18.3 months. The mean visual analogue scale (VAS) of the patients prior to surgery was 9.48, and the mean postoperative VAS was 1.63. According to Macnab's criteria, 145 patients had excellent and good results, and thus satisfactory results were obtained in 94.77% cases. Conclusion : In a posterolateral endoscopic lumbar discectomy, the difficult, non-contained disc is considered to be the most important factor impeding the success of surgery. By applying a semi-rigid flexible curved probe and using a transforaminal suprapedicular approach, good surgical results can be obtained, even in high grade, non-contained disc herniations.

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Section: Discussionmentioning

confidence: 99%

Strategies for Noncontained Lumbar Disc Herniation by an Endoscopic Approach : Transforaminal Suprapedicular Approach, Semi-Rigid Flexible Curved Probe, and 3-Dimensional Reconstruction CT with Discogram

Chae

Lee

et al. 2009

J Korean Neurosurg Soc

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“…Pain may continue because of muscular atrophy, developing secondary to longstanding inactivity (5,21). When atrophied muscles weaken, the load on intervertebral discs and surrounding ligaments increases (11). In addition, a reflex inhibition mechanism develops along with inactivity (39).…”

Section: Ogutluler Ozkara G Et Al: Physical Therapy After Lumbar Dismentioning

confidence: 99%

Assesment of the effectiveness of physical thraphy and rehabilitation programme starts immediately after lumbar disc surgery

Ozkara

Özgen²,

Özkara³

et al. 2013

Turkish Neurosurgery

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AIM:The aim of this randomized study was to compare exercise program to control group regarding pain, back disability, behavioural outcomes, global health measures and back mobility who underwent microdiscectomy operation. MATErIAL and METHods:Thirty patients who underwent lumbar microdiscectomy were randomized into exercıse and control groups. After surgery, patients in the exercıse group undertook a 12-week home based exercise program, started immediately postsurgery and concentrated on improving strength and endurance of the back, abdominal muscles, lower extremities and mobility of the spine and hips. Outcome measures were: Oswestry Disability Index (ODI), Beck Depression scale, lumbar schober, Visual Analogue Scale (VAS), return to work (return-to-work status), generic functional status (SF-36).rEsuLTs: Treatment compliance was high in both groups. Surgery improved pain, disability, general health status, lumbar mobility and behavioural status. After the exercise program, the exercise group showed further improvements in these measures at 12 week after surgery. CoNCLusIoN:A 12-week postoperative exercise program starting immediately after surgery can improve pain, disability, and spinal function in patients who have undergone microdiscectomy.KEywords: Exercise therapy, Lumbosacral radicular syndrome, Microdiscectomy ÖZ AMAÇ: Çalışma, mikrodiskektomi ameliyatı sonrası egzersiz verilen grup ile verilmeyen kontrol grubunun ağrı, disabilite, duygu durumu, genel sağlık durumu ve bel mobilitesinin karşılaştırmasını amaçlamaktadır. yÖNTEM ve GErEÇLEr: 30 hasta çalışmaya alındı. Egzersiz grubuna ameliyat sonrası erken dönemde başlanılan, 12 hafta süren, ev tabanlı, bel, bacak, abdominal kasları kuvvetlendirici, enduransı arttırıcı ve bel mobilizasyonu artıran egzersiz tedavisi verildi. Ölçüm sonuçlarımız: Oswestry Disability Indeksi (ODI), Beck Depresyon Skalası, Lomber Schober, Visual Analogue Scale (VAS), işe dönüş zamanı, genel fonksiyonel durum (SF-36).BuLGuLAr: Her iki grupta da tedaviye iyi yanıt alındı. Cerrahi girişim ile ağrı, disablite, genel sağlık durumu, duygu durum ve bel mobilitesinde iyileşme gözlemlendi. Egzersiz programından sonra, egzersiz grubu, kontrol grubuna kıyasla 12 hafta sonra ağrı, disabilte ve genel sağlık durumunda anlamlı iyileşme gösterdi. soNuÇ: Operasyon sonrası erken dönemde başlanılan 12 haftalık egzersiz tedavisi, mikrodiskektomi geçiren hastalarda ağrının, disabiltenin azalması ve genel sağlık durumunun iyileşmesinde etkili olabilir.ANAHTAr sÖZCÜKLEr: Egzersiz tedavisi, Lumbosakral radiküler sendrom, Mikrodiskektomi

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“…The order of surgery was identical to the general posterolateral procedure [6][7][8][9] . The patient was positioned prone on a Wilson frame.…”

Section: Case Reportmentioning

confidence: 99%

“…A rigid scope was then introduced down the cannula through the neural foramen. Disc decompression was then performed [6][7][8][9] . After dissecting around the space of the ruptured disc with a semi-rigid curved probe, the extruded disc material was removed with forceps, then the exiting nerve root was visible to move freely.…”

Section: Case Reportmentioning

confidence: 99%

Huge Psoas Muscle Hematoma due to Lumbar Segmental Vessel Injury Following Percutaneous Endoscopic Lumbar Discectomy

Kim¹,

Kim

et al. 2009

J Korean Neurosurg Soc

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We present a case of an acute psoas muscle hematoma following percutaneous endoscopic lumbar discectomy. A 60-year-old female who presented with far lateral lumbar disc herniation underwent endoscopic discectomy on the right side at the L4-5 level. On the second postoperative day, the patient complained of severe right flank and leg pain and her blood pressure decreased. A computed tomography scan showed a large acute psoas muscle hematoma at right L4-5 level. The patient was transfused with packed red blood cells and placed at absolute bed rest. After observing the patient in intensive care, the severe flank and leg pain subsided, but the mild back pain persisted. Although percutaneous endoscopic lumbar discectomy is an effective minimally invasive surgical technique for the treatment of lumbar disc herniation, this case highlights the inherent risks of acute lumbar segmental vessel injury.

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Fitness for work after surgery for lumbar disc herniation: a retrospective study

Cited by 58 publications

References 15 publications

Strategies for Noncontained Lumbar Disc Herniation by an Endoscopic Approach : Transforaminal Suprapedicular Approach, Semi-Rigid Flexible Curved Probe, and 3-Dimensional Reconstruction CT with Discogram

Strategies for Noncontained Lumbar Disc Herniation by an Endoscopic Approach : Transforaminal Suprapedicular Approach, Semi-Rigid Flexible Curved Probe, and 3-Dimensional Reconstruction CT with Discogram

Assesment of the effectiveness of physical thraphy and rehabilitation programme starts immediately after lumbar disc surgery

Huge Psoas Muscle Hematoma due to Lumbar Segmental Vessel Injury Following Percutaneous Endoscopic Lumbar Discectomy

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