Evaluation of the effectiveness of surgical methods for the treatment of recurrent lumbar disc herniation: a cohort retrospective study
| Autor: | Saidmirze Dzhamirzoevich Mirzametov, Nina Petrovna Alekseyeva, Aleksandr Sergeyevich Seleznev, Ivan Aleksandrovich Kruglov, Boris Vsevolodovich Gaidar, Maksim Nikolayevich Kravtsov, Vadim Anatolyevich Manukovskiy, Dmitry Vladimirovich Svistov |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Percutaneous RD1-811 medicine.medical_treatment microdiscectomy 03 medical and health sciences 0302 clinical medicine Discectomy transforaminal lumbar interbody fusion Medicine Orthopedics and Sports Medicine full-endoscopic lumbar discectomy recurrent lumbar disc herniation 030222 orthopedics business.industry Retrospective cohort study Intervertebral disc Perioperative Arthroplasty Surgery Anesthesiology and Pain Medicine medicine.anatomical_structure Cohort arthroplasty Implant total disc replacement business 030217 neurology & neurosurgery |
| Zdroj: | Хирургия позвоночника, Vol 18, Iss 2, Pp 34-43 (2021) |
| ISSN: | 2313-1497 1810-8997 |
| Popis: | Objective.To compare the effectiveness of surgical methods for treating patients with recurrent lumbar disc herniation.Material and Methods.The sample consisted of 160 patients operated on in 2014–2019 for recurrent lumbar disc herniation by percutaneous endoscopic discectomy (Group 1), microsurgical discectomy (Group 2), single-level transforaminal interbody fusion (Group 3) and single-level total intervertebral disc replacement (Group 4). The effectiveness of surgical treatment was evaluated using the NRS-11, ODI, and MacNab questionnaires.Results.Assessment of the pain syndrome severity and the vital activity level of patients revealed significant (p < 0.05) differences in favor of total intervertebral disc replacement. Excellent and good outcomes after arthroplasty according to MacNab criteria were noted in all patients in this group. Similar outcomes were reported in 77.5 % (31/40) of patients in the TLIF group, in 75.1 % (24/32) of patients in the percutaneous endoscopic discectomy group and in 72.6 % (45/62) of patients in the microdiscectomy group. The operation time and length of hospital stay were shorter in the endoscopic and microsurgical discectomy groups (p < 0.001). However, the lower incidence of complications and reoperations was observed in groups of posterior interbody fusion and arthroplasty (p > 0.05).Conclusion.Arthroplasty with the M6-L implant expands the possibilities of surgery for recurrent lumbar disc herniation. Total intervertebral disc replacement and posterior interbody fusion for recurrent lumbar disc herniation are more effective in comparison with decompressive operations, which is reflected in the improvement of clinical treatment outcomes, reduction of perioperative complications and frequency of repeated interventions. |
| Databáze: | OpenAIRE |
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