Microdiscectomy

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|]

When to Have Surgery for a Lumbar Herniated Disc

Ben Parr — Mon, 09 Mar 2009 14:19:39 -0700

A physician answers patient questions about determining when it is necessary to undergo surgery for a lumbar herniated disc.

More Spinal Stenosis Surgery Options

Ben Parr — Wed, 04 Mar 2009 12:22:02 -0800

Surgery for Leg Numbness from a Prolapsed Disc

Ben Parr — Thu, 26 Feb 2009 15:17:38 -0800

A physician answers patient questions about surgery for a prolapsed disc.

Question: Is low back surgery necessary for prolapsed disc?

I have a prolapsed disc at L5/S1 that just happened. After a few steroid injections, the leg pain is mostly gone; however there is still numbness in my lower leg and progressive loss of strength in my right leg.

Discectomy or Fusion to Treat Numbness and Leg Pain

Ben Parr — Mon, 16 Feb 2009 13:58:30 -0800

A physician answers patient questions about undergoing discectomy or fusion surgery to treat numbness and leg pain.

Question: Discectomy, spinal fusion, or another procedure?

I have seen an orthopedic surgeon. He wants to do a discectomy for numbness and pain in my left leg, but said that would not help my lower back and buttocks pain because of disc problems at L4-5. I think I'm saying this correctly.

Surgical Considerations for Herniated Discs and Scar Tissue

Ben Parr — Mon, 16 Feb 2009 13:58:24 -0800

A physician answers patient questions about considering surgery for herniated discs, scar tissue, and continued pain.

Rehabilitation and Exercise for Sciatica

Ben Parr — Mon, 16 Feb 2009 13:58:10 -0800

A physician answers patient questions about rehabilitation of the back when suffering from sciatica and leg pain.

Rehabilitation and Degenerative Disc Disease

Ben Parr — Fri, 13 Feb 2009 12:43:49 -0800

A physician answers patient questions about rehabilitation from degenerative disc disease.

Surgery Options for a Herniated Disc

Ben Parr — Wed, 30 Jul 2008 09:22:00 -0700

Microdiscectomy Spine Surgery: Risks, Complications, and Success Rates

Ben Parr — Fri, 11 Jul 2008 09:59:30 -0700

Usually, a microdiscectomy is performed on an outpatient basis (with no overnight stay in the hospital) or with one overnight in the hospital. Post-operatively, patients may return to a normal level of daily activity quickly.

¿Es Mi Dolor Ciática o Algo Más?

Ellen — Fri, 14 Mar 2008 13:52:46 -0700

Ciática--doler a lo largo del nervio sciatic grande que funciona de la parte posteriora más baja abajo de la parte posteriora de cada pierna--es una forma relativamente común de dolor de espalda y de dolor de la pierna. Sin embargo, la ciática del término se emplea mal a menudo, y los pacientes pueden intentar uno mismo-diagnosticar y uno mismo-tratan la causa incorrecta de su ciática o pueden realmente no tener ciática. Este boletín de noticias revienta algunos de los mitos comunes sobre ciática y da una descripción de sus síntomas, causas y opciones del tratamiento.

Microdiscectomy

spine-health — Fri, 04 Jan 2008 07:53:13 -0800

Definition

In a microdiscectomy or a microdecompression, a small portion of the bone over the nerve root and some of the disc material from under the nerve root is removed to relieve pressure on the nerve and provide room for the nerve to heal.

A microdiscectomy is typically performed for lumbar herniated disc and is more effective in relieving symptoms of leg pain than for low back pain.

Microdiscectomy: Lumbar Microdecompression Spine Surgery Video

spine-health — Thu, 03 Jan 2008 11:16:46 -0800