Treatment options and pathophysiology of degenerative spine disease

Gilliland, C. Dean; Sloan, Samuel

doi:10.1016/j.mpsur.2021.04.008

Cited by 2 publications

(1 citation statement)

References 7 publications

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“…There are no established guidelines to support one technique over the other 15 , 16 . Due to the pathophysiology of disc degeneration and herniation, there is controversy over the need for stabilization of the lumbar motion segment involved, as the resulting stenosis and instability are almost inevitable 17 . Loparev et al .…”

Section: Discussionmentioning

confidence: 99%

Management of recurrent lumbar disc herniation: a comparative analysis of posterior lumbar interbody fusion and repeat discectomy

Musa,

Makirov,

Chmutin

et al. 2024

Annals of Medicine &Amp; Surgery

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Background: For Recurrent lumbar disc herniation, many experts suggest a repeat discectomy without stabilization due to its minimal tissue manipulation, lower blood loss, shorter hospital stay, and lower cost, recent research on the role of instability in disc herniation has made fusion techniques popular among spinal surgeons. We compare the postoperative outcomes of posterior lumbar interbody fusion (PLIF) and repeat discectomy for same-level recurrent disc herniation. Methods: The patients included had previously undergone discectomy and presented with a same-level recurrent lumbar disc herniation. The patients were placed into two groups: 1) discectomy only, 2) posterior lumbar interbody fusion based on the absence or presence of segmental instability. Preoperative and postoperative Oswestry disability index scores, duration of surgery, blood loss, duration of hospitalization, and complications were analyzed. Results: The repeat discectomy and fusion groups had 40 and 34 patients respectively. The patients were followed up for 2.68 (1-4) years. There was no difference in the duration of hospitalization (3.73 vs. 3.29 d P 0.581) and operative time (101.25 vs. 108.82mins, P 0.48). Repeat discectomy had lower intraoperative blood loss, 88.75 mL (50–150) versus 111.47 mL (30-250) in PLIF (P 0.289). PLIF had better ODI pain score 4.21(0-10) versus 9.27(0-20) (P value of 0.018). Recurrence was 22.5% in repeat discectomy versus 0 in PLIF. Conclusion: PLIF and repeat discectomy for recurrent lumbar disc herniation have comparable intraoperative blood loss, duration of surgery and hospital stay. PLIF is associated with lower durotomy rates and better long-term pain control than discectomy. This is due to recurrence and progression of degenerative process in discectomy patients which are eliminated and slowed respectively by PLIF.

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Section: Discussionmentioning

confidence: 99%

Management of recurrent lumbar disc herniation: a comparative analysis of posterior lumbar interbody fusion and repeat discectomy

Musa,

Makirov,

Chmutin

et al. 2024

Annals of Medicine &Amp; Surgery

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Degenerative disc disease: pathophysiology, diagnosis, and classification

Musa,

Makirov,

Chmutin

et al. 2023

Bulletin of Neurology, Psychiatry and Neurosurgery

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Degenerative-dystrophic disease (DDD) and its complications is the most common condition in spinal neurosurgery. It affects about 80 % of all people over 80 and is the most common cause of disability in the middle-aged population. The main symptoms include mechanical back pain, symptoms of radiculitis and limping, limited mobility, and poor quality of life. Determining the pathophysiology, causes of DDD pain, as well as diagnostic tools and expected changes is paramount to improve patient care and satisfaction. In this paper, we present an overview of DDD pathophysiology, classification, and diagnosis.

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Treatment options and pathophysiology of degenerative spine disease

Cited by 2 publications

References 7 publications

Management of recurrent lumbar disc herniation: a comparative analysis of posterior lumbar interbody fusion and repeat discectomy

Management of recurrent lumbar disc herniation: a comparative analysis of posterior lumbar interbody fusion and repeat discectomy

Degenerative disc disease: pathophysiology, diagnosis, and classification

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