Open fenestration discectomy versus microscopic fenestration discectomy for lumbar disc herniation: a randomized controlled trial

Autor: Injam Ibrahim Sulaiman, Sherwan A. Hamawandi, Ameer Kadhim Al-Humairi
Rok vydání: 2020
Předmět:
Male
Microsurgery
lcsh:Diseases of the musculoskeletal system
Visual Analog Scale
Sports medicine
Decompression
medicine.medical_treatment
Intervertebral Disc Degeneration
Leg pain
law.invention
0302 clinical medicine
Visual analogue scale
Randomized controlled trial
law
Back pain
Diskectomy
Percutaneous
Orthopedics and Sports Medicine
Prospective Studies
030212 general & internal medicine
Oswestry disability index
Pain Measurement
Open fenestration discectomy
Lumbar Vertebrae
Middle Aged
Oswestry Disability Index
Treatment Outcome
Iraq
Lumbar disc herniation
Female
medicine.symptom
Intervertebral Disc Displacement
Research Article
Adult
Reoperation
medicine.medical_specialty
03 medical and health sciences
Rheumatology
Discectomy
medicine
Humans
Microdiscectomy
business.industry
Endoscopy
Length of Stay
Surgery
Orthopedic surgery
lcsh:RC925-935
business
030217 neurology & neurosurgery
Zdroj: BMC Musculoskeletal Disorders
BMC Musculoskeletal Disorders, Vol 21, Iss 1, Pp 1-11 (2020)
ISSN: 1471-2474
DOI: 10.1186/s12891-020-03396-x
Popis: Background Fenestration discectomy, for symptomatic lumbar disc herniation, is the most common surgical procedure in spine surgery. It can be done by open or microscopic procedures. This study compared the results of fenestration microdiscectomy with open fenestration discectomy in the treatment of symptomatic lumbar disc herniation as a relation to the functional outcome, leg pain, back pain, hospital stay, returns to daily activity, cost, recurrence, reoperation and type of surgery for recurrent disc herniation. Methods 60 patients age (29 - 50 years), with L4-L5 disc herniation, are divided randomly into group A- 30 patients underwent an open fenestration discectomy- and group B- 30 patients underwent fenestration microdiscectomy. All patients are assessed at 1 week, 3 months, 6 months, 12 months after surgery for Oswestry disability index and Visual analogue scale for back pain and leg pain and followed up for 4 years. Results In both groups, all patients have minimal disability by Oswestry Disability Index after surgery. There were significant differences between means of post-operative Visual Analogue Scale for back pain between these two groups after 1 week (3.7 in group A versus 2.2 in group B) (t = 13.28, P = There were no significant differences between two groups regarding post-operative VAS for leg pain, recurrence (5 patients in group A versus 4 patients in group B) and reoperation rate (2 patients in each group). There were significant differences between means of length of hospital stay (2.10 in group A versus 1.06 in group B) (P Conclusion Use of microscope in fenestration discectomy for treatment of symptomatic lumbar disc herniation can achieve the same goals of open fenestration regarding nerve root decompression and relief of leg pain with advantage of less back pain, less hospital staying and early return to daily activities with disadvantage of more cost with the use of microscope. With 4 years follow up, there was no significant deference in rate of recurrence and reoperation with the use of microscope but we found that type of surgery for recurrent cases may be less invasive if microscope was used in primary surgery. Trial registration NCT, NCT04112485. Registered 30 September 2019 - Retrospectively registered, https://clinicaltrials.gov/NCT04112485
Databáze: OpenAIRE
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