Comparison of the Minimally Invasive Tubular Transmuscular Approach with the Conventional Microsurgical Approach for Microsurgical Treatment of Lumbar Disk Herniation: A Prospective Randomized Study.
| Autor: | Pintea B; Department of Neurochirurgie, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bochum, Germany.; Department of Neurosurgery, Universitätsklinikum Bonn Zentrum für Nervenheilkunde, Bonn, Nordrhein-Westfalen, Germany., Krämer N; Department of Neurosurgery, Universitätsklinikum Bonn Zentrum für Nervenheilkunde, Bonn, Nordrhein-Westfalen, Germany., Müller A; Department of Neurosurgery, Universitätsklinikum Bonn Zentrum für Nervenheilkunde, Bonn, Nordrhein-Westfalen, Germany.; Department of Neurosurgery, Medizinische Fäkultat der RWTH Aachen, Aachen, Germany., Geiger MF; Department of Neurosurgery, Universitätsklinikum Bonn Zentrum für Nervenheilkunde, Bonn, Nordrhein-Westfalen, Germany.; Department of Neurosurgery, Medizinische Fäkultat der RWTH Aachen, Aachen, Germany., Podlogar M; Department of Neurosurgery, Universitätsklinikum Bonn Zentrum für Nervenheilkunde, Bonn, Nordrhein-Westfalen, Germany., Weber P; Department of Movement and Neurosciences, Deutsche Sporthochschule Köln, Koln, Nordrhein-Westfalen, Germany., Kristof RA; Department of Neurosurgery, Universitätsklinikum Bonn Zentrum für Nervenheilkunde, Bonn, Nordrhein-Westfalen, Germany.; Department of Neurosurgery, HELIOS Klinikum Meiningen, Meiningen, Thüringen, Germany. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of neurological surgery. Part A, Central European neurosurgery [J Neurol Surg A Cent Eur Neurosurg] 2021 May; Vol. 82 (3), pp. 218-224. Date of Electronic Publication: 2021 Jan 24. |
| DOI: | 10.1055/s-0040-1721019 |
| Abstrakt: | Background: The aim of this study is to compare the outcome of the minimally invasive transmuscular approach using a tubular retractor system (Metrx) with the conventional microsurgical standard approach (CM) for microsurgical treatment of lumbar disk herniation. Methods: This is a prospective randomized controlled study with a 1:1 distribution of patients in CM and Metrx study groups. Two hundred and twenty-seven (117 CM and 110 Metrx) patients were included. The primary outcome parameters are postoperative pain intensity reduction, length of hospitalization, postoperative quality of life, and daily life performance based on the standardized questionnaires: Visual Analog Scale (VAS), 36-Item Short Form Survey (SF-36), Oswestry Disability Index (ODI), and Prolo scores. The secondary outcome parameters are intraoperative variables: surgery duration, blood loss, and fluoroscopy dose. Results: There were no significant statistical differences in the primary outcome measures between the two groups with respect to postoperative pain relief (median VAS pre-op to 3 months post-op for sciatica: 9-2 [CM] vs. 8-2 [Metrx]; for lumbago: 7-2.5 [CM] vs. 6-3 [Metrx]), the length of hospitalization (median of 5 days), or the frequency of occupational reintegration after 3 months (59.1 vs. 60.7%). Conclusion: The microsurgical therapy of lumbar disk herniation via a Metrx approach is a safe and effective treatment option and is equivalent to the CM approach. Competing Interests: None declared. (Thieme. All rights reserved.) |
| Databáze: | MEDLINE |
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