Gardea LG, López AM

Language: Spanish
References: 22
Page: 162-165
PDF size: 76.31 Kb.

ABSTRACT

Even though the lumbar disc surgery is the commonest procedure that surgeons make in Neurosurgery, very little information is available to evaluate the short and long term evolution of patients operated as well as which technique is the most accurate. This work shows the good results when it has made hemilaminectomy with foraminotomy and discectomy for herniated lumbar disc disease. The surgical records of 202 patients, 88 were women and 114 men, who underwent surgical intervention for herniated lumbar disc disease in a 10-year period between 1996 and 2006 were reviewed. The author performed all these cases. The range age was 16 to 82. All the patients had radicular pain in a dermatomal pattern due to herniated lumbar disc disease with or without stenosis and they were evaluated with imaging studies as: MRI, myelography or CT. Two patients were operated on level L1-L2, 1 on L1 to L5, 2 on L2-L3, 2 on L2 to L4, 6 on L2 to L5, 29 on L3 to L4, 9 on L3 to S1, 46 on L4-L5, 1 on L4 to L6, 74 on L4 to S1, 28 on L5-S1, and 1 on L5 to S2. The outcome results were collected at a range from 1 month to 10 years 4 months. The main surgical procedure was hemilaminectomy with foraminotomy and discectomy. The outcome results were determinated using Macnab´s scale. 85% of the results were excellent, 8% good, 5% regular and 2% poor. There were 5 complications referred to surgery, 7 general complications and 3 infection cases. There were no instability cases.

REFERENCES

1. Claudius Thome, Martin Barth, Johann Scharf, Peter Schmiedek. Outcome after lumbar sequestrectomy compared with microdiscectomy: a prospective randomized study. J Neurosurg Spine 2005; 2:271-8.

2. Kudret Türeyen. One-level one-sided lumbar disc surgery with and without microscopic assistance: 1-year outcome in 114 consecutive patients. J Neurosurg Spine 2003; 99:247-50.

3. Mixter WJ, Barr JS. Rupture of the intervertebral disc with involvement of the spinal canal. N Engl J Med 1934; 211:210-5.

4. Caspar W. A new surgical procedure for lumbar disc herniation causing less tissue damage through a microsurgical approach. Adv Neurosurg 1977; 4:74-80.

5. Yasargil MG. Microsurgical operation of herniated lumbar disc. Adv Neurosurg 1977;4:81.

6. Williams RW. Microlumbar discectomy: a conservative surgical approach to the virgin herniated lumbar disc. Spine 1978; 3:175-82.

7. Goald HJ. Microlumbar discectomy: follow-up of 477 patients. J Microsurg 1980; 2:95-100.

8. Sachdev VP. Microsurgical lumbar discectomy: a personal series of 300 patients with at least 1 year of follow-up. Microsurgery 1986; 7:55-62.

9. Thomas AM, Afshar F. The microsurgical treatment of lumbar disc protrusion. Follow-up of 60 cases. J Bone Joint Surg Br 1974; 56:17-29.

10. Tullberg T, Isacson J, Weidenhielm L. Does microscopic removal of lumbar disc herniation lead to better results than the standard procedure? Results of a one-year randomized study. Spine 1993; 18:24-7.

11. Andrews DW, Lavyne MH: Retrospective analysis of microsurgical and standard lumbar discectomy. Spine 1990; 15:329-35.

12. Caspar W, Campbell B, Barbier DD. The Caspar microsurgical discectomy and comparison with a conventional standard lumbar disc procedure. Neurosurgery 1991; 28:78-87.

13. Silvers HR. Microsurgical versus standard lumbar discectomy. Neurosurgery 1988; 22:837-41.

14. AANS AAOS Long DM, Filtzer DLJ. Neurosurgery 1988. 69:61-71.

15. Rodman RH, Simeone FA. The spine 2d ed. Philadelphia: Saunders, 1982.

16. Macnab I. J Bone Joint Surg (Am) 1971; 53:891-903.

17. Wilson DH, Harbaugh R. Microsurgical and standard removal of the protruded lumbar disc: a comparative study. Neurosurgery 1981; 8:422-7.

18. Kudret Türeyen. One-level one- side lumbar disc surgery with and without microscopic assistance: 1-year outcome in 114 consecutive patients. J Neurosurg (Spine 3) 2003; 99:247-50.

19. Francois Porchet, Anne Chollet-Bornand, Nicolas de Tribolet. Long-term follow up of patients surgically treated by the farlateral approach for foraminal and extraforaminal lumbar disc herniations. J Neurosurg (Spine 1) 1999; 90:59-66.

20. Davis RA. A long term analysis of 984 surgically treated herniated lumbar discs. J Neurosurg 1984; 80:415-21.

21. Prolo DJ, Oaklund SA, Butcher M. Toward uniformity in evaluating results of lumbar spine operations. A paradigm applied to posterior lumbar interbody fusions. Spine 1986; 11:601-6.

22. Markus Wenger, Thomas-Marc Markwalder. A novel surgical treatment of lumbar disc herniation in patients with long-standing degenerative disc disease. J Neurosurg Spine 2005; 2:515-20.