Effectiveness of Sciatica Treatment, Herniated Disc Surgeries Compared in Recent Study

cmaynard — Wed, 15 Jul 2009 09:27:47 -0700

July 15, 2009
by: Sylvia Marten

Examining the effectiveness of conventional microdiscectomy and tubular disectomy surgeries for treatment of [url:996,type=|node|,content=|sciatica symptoms|] resulting from a [url:885,type=|node|,content=|herniated disc|], a recent study found and opined that the minimally invasive, tubular surgery did not result in better outcomes for patients despite such claims in the past.

[url:1584,type=|node|,content=|conventional microdiscectomy|]. The most commonly performed surgery for patients with sciatic leg pain from disc herniation, [url:5991,type=|node|,content=|microdiscectomy|] (also known as lumbar decompression surgery) entails the removal of a small portion of the bone over the nerve root and/or disc material under the nerve root to relieve neural impingement and provide more room to heal.
[url:6025,type=|node|,content=|tubular discectomy|]. Introduced in 1997, tubular discectomy involves a similar procedure to the one described above, with the exception that it is performed through a tubular device. This type of herniated disc surgery has been described as producing less tissue damage and resulting in a faster rate of recovery, the latter point serving as the basis of examination for the Sciatica Micro-Endoscopic Discectomy trial.

Performed by researchers in the Netherlands, this trial involved 328 patients (ages 18 to 70 years) who:

had persistent leg pain from lumbar herniated discs for more than 8 weeks
were hospitalized in 7 general hospitals in the Netherlands from January 2005 to October 2006
were randomized to either a tubular discectomy (approximately 167 patients) or conventional microdiscectomy (161 patients).

A blind follow up was conducted a year later, with functional ability, pain and a self-view of recovery assessed via a series of questionnaires and surveys.

Findings on Microdiscectomy and Tubular Discectomy

According to the study, conventional microdiscectomy produced more favorable results than tubular discectomy after one year for:

functionality. The mean score on the Roland-Morris Disability Questionnaire (RDQ), which has a 0-23 score range with higher scores indicative of worse functional status, was 3.4 for conventional microdiscectomy and 4.7 for tubular discectomy.
leg pain. On the visual analog scale, the 1-year mean difference was in favor of conventional microdiscectomy (with scores of 4.2 mm for leg pain and 3.5 mm for [url:145,type=|term|,content=|back pain|]).
self-reports of recovery. 120 of 151 patients (79%) who had conventional microdiscectomy reported good recovery a year later while 107 of 156 of patients (69%) who had tubular discectomy reported good recovery a year after the minimally-invasive procedure.

It should be known that this randomized control trial by no means knocks the validity of tubular disectomy as a minimally-invasive procedure for herniated discs; rather, it challenges certain claims like it increasing the rates of recovery.

Source: JAMA

More on This Topic

[url:1001,type=|node|,content=|Sciatic Nerve Anatomy and Sciatica Symptoms|]
[url:1016,type=|node|,content=|The Truth about Sciatica|]
[url:715,type=|node|,content=|Lumbar Herniated Disc|]
[url:884,type=|node|,content=|Treatment Options for a Lumbar Herniated Disc|]
[url:9574,type=|node|,content=|Surgery Options for a Herniated Disc|]
[url:18207,type=|node|,content=|Lower Back Pain after Surgery|]
[url:7996,type=|node|,content=|Sciatica Treatments|]

What's a Herniated Disc, Pinched Nerve, Bulging Disc...?

spine-health — Tue, 11 Dec 2007 21:26:50 -0800

Clinical Trials of Medical Products and Medical Devices: What You Need to Know

spine-health — Wed, 12 Dec 2007 00:43:34 -0800

There is constant innovation throughout the medical field and every year hundreds of new medications, devices and surgical techniques are developed and tested. The vehicle for testing drugs and devices (such as artificial discs or spinal fusion implants) prior to allowing them for use by the general public is usually a clinical trial—a controlled test where the new product is provided to participants who have given their consent, and the results are tabulated and documented to determine if the product is safe and effective for a specified condition or disease.

Herniated Disc Trials

Effectiveness of Sciatica Treatment, Herniated Disc Surgeries Compared in Recent Study

Findings on Microdiscectomy and Tubular Discectomy

What's a Herniated Disc, Pinched Nerve, Bulging Disc...?

Clinical Trials of Medical Products and Medical Devices: What You Need to Know