Varela HA, Tamakloe K, Mosquera BG, Hernández CI, Casares DJA, Medrano GR

Language: Spanish
References: 23
Page: 25-31
PDF size: 402.47 Kb.

ABSTRACT

Objective: To analyze the results of the application of ambulatory surgery for treatment of lumbar disc herniation in Camagüey.
Methods: A cuasiexperimental investigation was carried out with patients treated by means of lumbar discectomy in an ambulatory way at the neurosurgery department in the "Manuel Ascunce Domenech" University Hospital in Camagüey from the first January 2010 up to December 31 2012. Patients that could not be located for an interview after two months minimum starting from the moment of the intervention were excluded. Using the statistical package S.P.S.S v 18.0 distribution of frequencies and percent’s, median comparison test, ANOVA and binomial logistical regression was applied.
Results: 80 patients were studied, most were males between 41 and 50 years, with disc herniation located at L4–L5 or L5–S1. A significant values reduction on visual analogical scale for lumbar pain, radicular pain and Oswestry´s index after the treatment was proven. All patients referred high satisfaction with the ambulatory procedure. Necessity of hospital admission was related with postoperative complications and ambulatory treatment failure with low values on visual analogical scale for preoperative radicular pain.
Conclusions: Ambulatory surgery for lumbar disc herniation is more efficient than the traditional method of hospitalization. The bases for success reside fundamentally on appropriate selection of patients, the correct estimation of anesthetic risk and performing a proper surgical technique.

REFERENCES

1. Andersson J B G, Biyani A, Ericksen T S. Lumbar Disc Disease. En: Herkowitz NH, Garfin RS, Eismont JF, Bell RG, Balderston AR, eds. The Spine. Philadelphia: Saunders; 2011. p. 846–86.

2. Bokov A, Isrelov A, Skorodumov A, Aleynik A, Simonov A, Mlyavykh S. An analysis of reasons for failed back surgery syndrome and partial results after different types of surgical lumbar nerve root decompression. Pain Physician. 2011;14(6):545–57.

3. McMillan M R. Outpatient percutaneus and endoscopic surgery in interventional pain management. J S C Assoc. 2011;107(6):205–8.

4. Varela HA, Mosquera BG, Pardo CG, Suárez MD, Hernández C I. Seguridad de la práctica de la discectomía lumbar bajo régimen ambulatorio. Rev Arch Med Camagüey. 2012;16(2):1221–29.

5. Newfield P, Cottrell JE, eds. Handbook of Neuroanesthesia. New York: Lippincott Williams and Wilkins; 2007.

6. Hernández–Padrón E, Dueñas–Ros F. Caracterización por imaginología de la hernia discal lumbar en pacientes operados. MediSur. 2009;7(3):3–9.

7. Aroche–Lafargue Y, Pons–Porrata M L, de la Cruz–De Oña A, González–Ferro I, Riley–Fernández D. Caracterización clínica e imagenológica de la hernia discal mediante resonancia magnética. MEDISAN. 2012;16(8):1274–83.

8. Nicassio N, Bobicchio P, Umari M, Tacconi L. Lumbar microdiscectomy under epidural anaesthesia with the patient in the sitting position: a prospective study. J Clin Neuroci. 2010;17(12):1537–40.

9. Yoshikawa H, Andoh T, Tarumoto Y, Yamada R, Akihisa Y, Kudoh I. Usefulness of epidural anesthesia for percutaneus endoscopic lumbar discectomy (PELD). Masui. 2011;60(12):1370–7.

10. Jiong G J, Yang H, Tang T. Long–term outcomes of the revision open lumbar discectomy by fenestration: a fallow–up study of more than 10 years. Int Orthop. 2009;33(5):1341–5.

11. Valli A D, Fernandez J A, Vinicius G M, Ghizoni E, Adriano EL. Mocrodiscectomia lombar tubular com o uso de siringas descartáveis de diámetros progressivos: resultados cirúrgicos. Coluna/Columna. 2010;9(2):145–9.

12. Postacchini F, Postacchini R. Operative Management of lumbar disc herniation. The Evolution of Knowledge and Surgical Techniques in the Last Century. En: Masini MA, Menchetti MP, eds. Advances in Minimally Invasive Surgery and Therapy for Spine and Nerves. New York: Springer–Verlag; 2011. p. 17–21.

13. Bono MCh, Schoenfeld A, Garfin RS. Lumbar Disc Herniations. En: Herkowitz NH, Garfin RS, Eismont JF, Bell RG, Balderston AR, eds. The Spine. Philadelphia: Saunders; 2011. p. 887–914.

14. Castro M, Cánous L, Martínez J, Pastorb A, Segado I, Rochaa F, et al. Discólisis percutánea con ozono: nuestra experiencia. Rev. Soc. Esp. Dolor. 2009;16(7):405–9.

15. Lorenço–Kallás J, Loyola–Godoy B, Fantezia–Andraus C, Gonçalves–de Carvalho F, Cosenza–Andraus ME. Nucleoplasty as a therapeutic option for lumbar dis degeneration related pain: a retrospective study of 396 cases. Arq Neuro–Psiquiatr. 2013;71(1):46–50.

16. Arts MP, Peul WC. Management of sciatica due to lumbar disc herniation in the Netherlands: a survey among spine surgeons. J Neurosurg Spine. 2008;9(1):32– 9.

17. Ryang MY, Oertel EM, Mayfrank L, Gilsbach MJ, Rohde V. Standard open microdiscectomy versus minimal access trocar microdiscectomy: Results of a prospective randomized study. Neurosurgery. 2008; 62 (1): 174–82.

18. Vialle–Roberto L, Vialle–Neves E, Suárez–Hena JE, Giraldo G. Hérnia discal lombar. Rev.bras.ortop.2010; 45(1): 17–22.

19. Apkarian AV, Baliki MN, Geha PY. Towards a theory of chronic pain. Prog Neurobiol. 2009;87(29):81–97.

20. Bogduk N. On the definitions and physiology of back pain, referred pain and radicular pain. Pain. 2009;147:17–9.

21. Suri P, Hunter JD, Jouve C, Hortigan C, Limke J, Pena E, et al. Nonsurgical Treatment of Lumbar Disk Herniation: Are Outcomes Different in Older Adults? J Am Geriatr Soc. 2011;54(3):423–9.

22. Martínez–Quiñones VJ, Aso–Escario J, Consolini F, Arregui–Calvo R. Regresión espontánea de hernias discales intervertebrales. A propósito de una serie de 37 casos. Neurocirugía. 2010;21(2):108–17.

23. Wang H, Huang B, Zheng W, Li Ch, Zang Z, Wang J, et al. Comparison of early and late presutaneous endoscopic lumbar discectomy for lumbar disc herniation. Acta Neurochirug. 2013;155(10):1931–36.