Standard Open Microdiscectomy Versus Minimal Access Trocar Microdiscectomy

Ryang, Yu‐Mi; Oertel, Markus Florian; Mayfrank, L.; Gilsbach, Joachim M.; Rohde, Veit

doi:10.1227/01.neu.0000311075.56486.c5

Cited by 112 publications

(99 citation statements)

References 30 publications

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“…A total of 1886 titles and abstracts were preliminarily reviewed, of which 11 studies [11][12][13][14][15][16][17][18][19][20][21] eventually satisfied the eligibility criteria (Fig. 1).…”

Section: Search Resultsmentioning

confidence: 99%

“…4). Longterm VAS scores were available in 3 of the studies [11,17,21]. The study found no significant differences between the ILMI and MD groups (SMD = 0.13, 95% CI −0.04, 0.30; p = 0.14) (Fig.…”

Section: Back Painmentioning

confidence: 98%

“…8). Seven RCTs [11,13,14,16,17,21] reported long-term ODI scores (SMD = 0.11, 95% CI −0.03, 0.25; p = 0.14) (Fig. 9).…”

Section: Functional Recoverymentioning

confidence: 99%

“…Six trials [11][12][13][19][20][21] reported an adequately generated allocation sequence, and only one trial [11] reported allocation concealment. Two studies [12,17] reported using single-blinded outcome assessors, and two studies [11,20] reported using doubleblinded; the other studies did not specify a blinding method. The methodological quality of included studies is presented in Fig.…”

Section: Quality Assessmentmentioning

confidence: 99%

See 3 more Smart Citations

A meta-analysis of interlaminar minimally invasive discectomy compared to conventional microdiscectomy for lumbar disk herniation

Wang

Sun

et al. 2014

Clinical Neurology and Neurosurgery

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“…A total of 1886 titles and abstracts were preliminarily reviewed, of which 11 studies [11][12][13][14][15][16][17][18][19][20][21] eventually satisfied the eligibility criteria (Fig. 1).…”

Section: Search Resultsmentioning

confidence: 99%

Section: Back Painmentioning

confidence: 98%

“…8). Seven RCTs [11,13,14,16,17,21] reported long-term ODI scores (SMD = 0.11, 95% CI −0.03, 0.25; p = 0.14) (Fig. 9).…”

Section: Functional Recoverymentioning

confidence: 99%

Section: Quality Assessmentmentioning

confidence: 99%

See 2 more Smart Citations

A meta-analysis of interlaminar minimally invasive discectomy compared to conventional microdiscectomy for lumbar disk herniation

Wang

Sun

et al. 2014

Clinical Neurology and Neurosurgery

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“…Huang et al [15] reported increased C-reactive protein and interleukin-6 serum levels in open discectomies, and Arts et al [4] demonstrated that within-patient relative change in CPK is lower in minimally invasive spine approaches, but failed to show any difference between MED and MSD in terms of multifidus muscle atrophy [1]. With respect to clinical results, randomised trials comparing tubular microdiscectomy or microendoscopic discectomy with conventional microdiscectomy failed to demonstrate the superiority of tubular techniques in early or long-term outcomes [2,3,12,20,30,32,33].…”

Section: Discussionmentioning

confidence: 99%

Complications of endoscopic microdiscectomy using the EASYGO! system: is there any difference with conventional discectomy during the learning-curve period?

et al. 2012

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Between 25 and 30 cases are needed to reach the learning curve's asymptote of MED. Even during this initial learning period MED is a safe procedure, with comparable results to those obtained with conventional MSD and with a similar complication rate. The key points for reducing intraoperative complications are an adequate expertise in MSD, a precise selection of initial cases, a proper surgical planning and a careful technique, which are mandatory to avoid unnecessary neurological injury in an otherwise secure surgical approach.

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Tubular Diskectomy vs Conventional Microdiskectomy for Sciatica<subtitle>A Randomized Controlled Trial</subtitle>

Arts

Brand²,

Akker³

et al. 2009

JAMA

221

157

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CIATICA OR LUMBOSACRAL RAdicular syndrome affects millions of individuals worldwide and is typically caused by disk herniation. 1 The natural course is usually favorable. Surgery is offered to patients with persistent pain that is refractory to conservative treatment. [2][3][4] Since the first successful lumbar disk operation, described by Mixter and Barr 5 in 1934, a variety of less invasive techniques have been developed. With the introduction of the microscope, the original laminectomy was refined into open microdiskectomy, which is now the most common procedure. [6][7][8] In 1997, Foley and Smith 9 introduced the minimally invasive technique of transmuscular tubular diskectomy. The rationale behind replacing the conventional subperiosteal muscle dissection by the muscle-splitting transmuscular approach of tubular diskectomy is less tissue damage, resulting in a faster rate of recovery but with similar long-term outcomes. Patients are expected to have reduced postoperative back pain, thus allowing quicker mobilization and contributing to shorter hospitalization and faster resumption See also Patient Page. Context Conventional microdiskectomy is the most frequently performed surgery for patients with sciatica due to lumbar disk herniation. Transmuscular tubular diskectomy has been introduced to increase the rate of recovery, although evidence is lacking of its efficacy.Objective To determine outcomes and time to recovery in patients treated with tubular diskectomy compared with conventional microdiskectomy. Design, Setting, and PatientsThe Sciatica Micro-Endoscopic Diskectomy randomized controlled trial was conducted among 328 patients aged 18 to 70 years who had persistent leg pain (Ͼ8 weeks) due to lumbar disk herniations at 7 general hospitals in the Netherlands from January 2005 to October 2006. Patients and observers were blinded during the follow-up, which ended 1 year after final enrollment. Interventions Tubular diskectomy (n=167) vs conventional microdiskectomy (n=161).Main Outcome Measures The primary outcome was functional assessment on the Roland-Morris Disability Questionnaire (RDQ) for sciatica (score range: 0-23, with higher scores indicating worse functional status) at 8 weeks and 1 year after randomization. Secondary outcomes were scores on the visual analog scale for leg pain and back pain (score range: 0-100 mm) and patient's self-report of recovery (measured on a Likert 7-point scale). ResultsBased on intention-to-treat analysis, the mean RDQ score during the first year after surgery was 6.2 (95% confidence interval [CI], 5.6 to 6.8) for tubular diskectomy and 5.4 (95% CI, 4.6 to 6.2) for conventional microdiskectomy (betweengroup mean difference, 0.8; 95% CI, −0.2 to 1.7). At 8 weeks after surgery, the RDQ mean (SE) score was 5.8 (0.4) for tubular diskectomy and 4.9 (0.5) for conventional microdiskectomy (between-group mean difference, 0.8; 95% CI, −0.4 to 2.1). At 1 year, the RDQ mean (SE) score was 4.7 (0.5) for tubular diskectomy and 3.4 (0.5) for conventional microdiskectomy (between-gr...

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Standard Open Microdiscectomy Versus Minimal Access Trocar Microdiscectomy

Cited by 112 publications

References 30 publications

A meta-analysis of interlaminar minimally invasive discectomy compared to conventional microdiscectomy for lumbar disk herniation

A meta-analysis of interlaminar minimally invasive discectomy compared to conventional microdiscectomy for lumbar disk herniation

Complications of endoscopic microdiscectomy using the EASYGO! system: is there any difference with conventional discectomy during the learning-curve period?

Tubular Diskectomy vs Conventional Microdiskectomy for Sciatica<subtitle>A Randomized Controlled Trial</subtitle>

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