Research Article
Year 2019,
Volume: 41 Issue: 3, 637 - 646, 30.09.2019
Abstract
References
- Grantham SA. Herniated lumbar disc. Am J Surg. 1952;83(4):531–537.
- Vroomen PCAJ, De Krom MCTFM, Knottnerus JA. When does the patient with a disc herniation undergo lumbosacral discectomy? J Neurol Neurosurg Psychiatry. 2000;68(1):75-79
- Heliövaara M, Knekt P, Aromaa A. Incidence and risk factors of herniated lumbar intervertebral disc or sciatica leading to hospitalization. J Chronic Dis. 1987;40(3):251-258.
- Li Y, Fredrickson V, Resnick DK. How Should We Grade Lumbar Disc Herniation and Nerve Root Compression? A Systematic Review. Clin Orthop Relat Res. 2015;473(6):1896–1902.
- Calina N, Serban D, Constantinescu A, DiGiorgio A, Tender G. Microdiscectomy. In: Minimally Invasive Spine Surgery Techniques. 2018. p. 5–21.
- Koebbe CJ, Maroon JC, Abla A, El-Kadi H, Bost J. Lumbar microdiscectomy: a historical perspective and current technical considerations. Neurosurg Focus. 2002;13(2):E3
- Ran J, Hu Y, Zheng Z, Zhu T, Zheng H, Jing Y, et al. Comparison of discectomy versus sequestrectomy in lumbar disc herniation: A meta-analysis of comparative studies. PLoS One. 2015;10(3):e0121816.
- Fakouri B, Shetty NR, White TCH. Is Sequestrectomy a Viable Alternative to Microdiscectomy? A Systematic Review of the Literature. Clin Orthop Relat Res. 2015;473(6):1957–1962.
- Azarhomayoun A, Chou R, Shirdel S, Lakeh MM, Vaccaro AR, Rahimi-Movaghar V. Sequestrectomy versus conventional microdiscectomy for the treatment of a lumbar disc herniation: A systematic review. Spine. 2015;40(24):E1330-1339.
- Aydin Y, Ziyal IM, Duman H, Türkmen CS, Başak M, Ahin Y. Clinical and radiological results of lumbar microdiskectomy technique with preserving of ligamentum flavum comparing to the standard microdiskectomy technique. Surg Neurol. 2002;57(1):5-13
- Özay R, Ogur T, Durmaz HA, Turkoglu E, Caglar YS, Sekerci Z, et al. Revisiting Ligament-Sparing Lumbar Microdiscectomy: When to Preserve Ligamentum Flavum and How to Evaluate Radiological Results for Epidural Fibrosis. World Neurosurg. 2018;114:e378–387.
- Zanoli G, Strömqvist B, Jönsson B. Visual analog scales for interpretation of back and radicular pain intensity in patients operated for degenerative lumbar spine disorders. Spine (Phila Pa 1976). 2001;26(21):2375-2380.
- Fairbank JCT, Pynsent PB. The oswestry disability index. Spine (Phila Pa 1976). 2000;25(22):2940-2952
- Macnab I. Negative disc exploration. An analysis of the causes of nerve-root involvement in sixty-eight patients. J Bone Joint Surg Am. 1971;53(5):891-903.
- Yong-Hing K, Reilly J, Kirkaldy-Willis WH. The ligamentum flavum. Spine (Phila Pa 1976). 1976; 1(4):226-234.
- Nachemson AL, Evans JH. Some mechanical properties of the third human lumbar interlaminar ligament (ligamentum flavum). J Biomech. 1968;1(3):211-220.
- Ozer AF, Oktenoglu T, Sasani M, Bozkus H, Canbulat N, Karaarslan E, et al. Preserving the ligamentum flavum in lumbar discectomy: A new technique that prevents scar tissue formation in the first 6 months postsurgery. Neurosurgery. 2006 ;59(1 Suppl 1):ONS126-133;
- Yüce İ, Kahyaoğlu O, Çavuşoğlu H, Aydın Y. Surgical outcome and efficacy of lumbar microdiscectomy technique with preserving of ligamentum flavum for recurrent lumbar disc herniations. J Clin Neurosci. 2019;63:43-47.
- Kim Y-K, Kang D, Lee I, Kim S-Y. Differences in the Incidence of Symptomatic Cervical and Lumbar Disc Herniation According to Age, Sex and National Health Insurance Eligibility: A Pilot Study on the Disease’s Association with Work. Int J Environ Res Public Health. 2018;15(10):2094.
- Kast E, Oberle J, Richter HP, Börm W. Success of simple sequestrectomy in lumbar spine surgery depends on the competence of the fibrous ring a prospective controlled study of 168 patients. Spine (Phila Pa 1976). 2008;33(14):1567-1571.
- Fakouri B, Patel V, Bayley E, Srinivas S. Lumbar microdiscectomy versus sequesterectomy/free fragmentectomy: A long-term (>2 y) retrospective study of the clinical outcome. J Spinal Disord Tech. 2011;24(1):6-10.
- Baek GS, Kim YS, Lee MC, Song JW, Kim SK, Kim IH. Fragmentectomy versus conventional microdiscectomy in single-level lumbar disc herniations: Comparison of clinical results and recurrence rates. J Korean Neurosurg Soc. 2012;52(3):210-214.
- Kotil K, Köksal NS, Kayaci S. Long term results of lumbar sequestrectomy versus aggressive microdiscectomy. J Clin Neurosci. 2014 Oct;21(10):1714-1718.
- Shamji MF, Bains I, Yong E, Sutherland G, Hurlbert RJ. Treatment of herniated lumbar disk by sequestrectomy or conventional diskectomy. World Neurosurg. 2014;82(5):879-883.
- Thomé C, Barth M, Scharf J, Schmiedek P. Outcome after lumbar sequestrectomy compared with microdiscectomy: a prospective randomized study. J Neurosurg Spine. 2005;2(3):271-278.
- Carragee EJ, Spinnickie AO, Alamin TF, Paragioudakis S. A prospective controlled study of limited Versus subtotal posterior discectomy: Short-term outcomes in patients with herniated lumbar intervertebral discs and large posterior anular defect. Spine (Phila Pa 1976). 2006;31(6):653-657.
- Kast E, Mohr K, Richter H-P, Börm W. Results of simple fragment excision in lumbar disc surgery. Orthopade. 2005;34(9):931-937
- Schick U, Elhabony R. Prospective comparative study of lumbar sequestrectomy and microdiscectomy. Minim Invasive Neurosurg. 2009;52(4):180-185.
- Boyaci S, Aksoy K. Long-term clinical outcome of the lumbar microdiscectomy and fragmentectomy: A prospective study. Neurosurg Q. 2016;26(2):109-115
- Barth M, Weiss C, Thomé C. Two-year outcome after lumbar microdiscectomy versus microscopic sequestrectomy - Part 1: Evaluation of clinical outcome. Spine (Phila Pa 1976). 2008;33(3):265-272.
Comparison of conventional microdiscectomy and sequestrectomy in ligamentum flavum preserved lumbar disc herniation surgery
Abstract
Objective: Comparison
of conventional microdiscectomy with sequestrectomy in lumbar disc herniation
(LDH) surgery with ligamentum flavum (LF) preservation technique.
Method: Study
design was approved by local ethics committee. We retrospectively reviewed LDH 320
patients operated for disc pathologies in L3 - S1 levels in our clinic between
June 2015 - June 2017. Two groups were formed in the study: sequestrectomy and
conventional microdiscectomy. Demographic, operational and outcome data were
compared between the groups.
Results: Sequestrectomy group included 71 patients and conventional microdiscectomy
group included 60 patients. There was no statistically significant difference
between the groups in terms of age, sex, comorbidities, smoking, body mass
index, disc pathology level, operative complications, amount of bleeding,
length of stay, disc recurrence and low back pain, radicular pain, quality of
life, surgical success and satisfaction results. Satisfactory improvement rates
were found in the conventional discectomy (85%) and sequestrectomy group
(91.5%) in mid-term follow-up. Operation time (mean 61.1 vs 94.6 min), and early postoperative opioid requirement
(14.1% vs 27.1%) were significantly lower in the sequestrectomy group.
Conclusions: In LDH surgery with LF preservative technique, satisfactory results were obtained with both
methods with comparable. Recurrence rates and outcome. However, sequestrectomy is appropriate in cases
without a wide annular defect due to the short operation time, low opioid
requirement.
References
- Grantham SA. Herniated lumbar disc. Am J Surg. 1952;83(4):531–537.
- Vroomen PCAJ, De Krom MCTFM, Knottnerus JA. When does the patient with a disc herniation undergo lumbosacral discectomy? J Neurol Neurosurg Psychiatry. 2000;68(1):75-79
- Heliövaara M, Knekt P, Aromaa A. Incidence and risk factors of herniated lumbar intervertebral disc or sciatica leading to hospitalization. J Chronic Dis. 1987;40(3):251-258.
- Li Y, Fredrickson V, Resnick DK. How Should We Grade Lumbar Disc Herniation and Nerve Root Compression? A Systematic Review. Clin Orthop Relat Res. 2015;473(6):1896–1902.
- Calina N, Serban D, Constantinescu A, DiGiorgio A, Tender G. Microdiscectomy. In: Minimally Invasive Spine Surgery Techniques. 2018. p. 5–21.
- Koebbe CJ, Maroon JC, Abla A, El-Kadi H, Bost J. Lumbar microdiscectomy: a historical perspective and current technical considerations. Neurosurg Focus. 2002;13(2):E3
- Ran J, Hu Y, Zheng Z, Zhu T, Zheng H, Jing Y, et al. Comparison of discectomy versus sequestrectomy in lumbar disc herniation: A meta-analysis of comparative studies. PLoS One. 2015;10(3):e0121816.
- Fakouri B, Shetty NR, White TCH. Is Sequestrectomy a Viable Alternative to Microdiscectomy? A Systematic Review of the Literature. Clin Orthop Relat Res. 2015;473(6):1957–1962.
- Azarhomayoun A, Chou R, Shirdel S, Lakeh MM, Vaccaro AR, Rahimi-Movaghar V. Sequestrectomy versus conventional microdiscectomy for the treatment of a lumbar disc herniation: A systematic review. Spine. 2015;40(24):E1330-1339.
- Aydin Y, Ziyal IM, Duman H, Türkmen CS, Başak M, Ahin Y. Clinical and radiological results of lumbar microdiskectomy technique with preserving of ligamentum flavum comparing to the standard microdiskectomy technique. Surg Neurol. 2002;57(1):5-13
- Özay R, Ogur T, Durmaz HA, Turkoglu E, Caglar YS, Sekerci Z, et al. Revisiting Ligament-Sparing Lumbar Microdiscectomy: When to Preserve Ligamentum Flavum and How to Evaluate Radiological Results for Epidural Fibrosis. World Neurosurg. 2018;114:e378–387.
- Zanoli G, Strömqvist B, Jönsson B. Visual analog scales for interpretation of back and radicular pain intensity in patients operated for degenerative lumbar spine disorders. Spine (Phila Pa 1976). 2001;26(21):2375-2380.
- Fairbank JCT, Pynsent PB. The oswestry disability index. Spine (Phila Pa 1976). 2000;25(22):2940-2952
- Macnab I. Negative disc exploration. An analysis of the causes of nerve-root involvement in sixty-eight patients. J Bone Joint Surg Am. 1971;53(5):891-903.
- Yong-Hing K, Reilly J, Kirkaldy-Willis WH. The ligamentum flavum. Spine (Phila Pa 1976). 1976; 1(4):226-234.
- Nachemson AL, Evans JH. Some mechanical properties of the third human lumbar interlaminar ligament (ligamentum flavum). J Biomech. 1968;1(3):211-220.
- Ozer AF, Oktenoglu T, Sasani M, Bozkus H, Canbulat N, Karaarslan E, et al. Preserving the ligamentum flavum in lumbar discectomy: A new technique that prevents scar tissue formation in the first 6 months postsurgery. Neurosurgery. 2006 ;59(1 Suppl 1):ONS126-133;
- Yüce İ, Kahyaoğlu O, Çavuşoğlu H, Aydın Y. Surgical outcome and efficacy of lumbar microdiscectomy technique with preserving of ligamentum flavum for recurrent lumbar disc herniations. J Clin Neurosci. 2019;63:43-47.
- Kim Y-K, Kang D, Lee I, Kim S-Y. Differences in the Incidence of Symptomatic Cervical and Lumbar Disc Herniation According to Age, Sex and National Health Insurance Eligibility: A Pilot Study on the Disease’s Association with Work. Int J Environ Res Public Health. 2018;15(10):2094.
- Kast E, Oberle J, Richter HP, Börm W. Success of simple sequestrectomy in lumbar spine surgery depends on the competence of the fibrous ring a prospective controlled study of 168 patients. Spine (Phila Pa 1976). 2008;33(14):1567-1571.
- Fakouri B, Patel V, Bayley E, Srinivas S. Lumbar microdiscectomy versus sequesterectomy/free fragmentectomy: A long-term (>2 y) retrospective study of the clinical outcome. J Spinal Disord Tech. 2011;24(1):6-10.
- Baek GS, Kim YS, Lee MC, Song JW, Kim SK, Kim IH. Fragmentectomy versus conventional microdiscectomy in single-level lumbar disc herniations: Comparison of clinical results and recurrence rates. J Korean Neurosurg Soc. 2012;52(3):210-214.
- Kotil K, Köksal NS, Kayaci S. Long term results of lumbar sequestrectomy versus aggressive microdiscectomy. J Clin Neurosci. 2014 Oct;21(10):1714-1718.
- Shamji MF, Bains I, Yong E, Sutherland G, Hurlbert RJ. Treatment of herniated lumbar disk by sequestrectomy or conventional diskectomy. World Neurosurg. 2014;82(5):879-883.
- Thomé C, Barth M, Scharf J, Schmiedek P. Outcome after lumbar sequestrectomy compared with microdiscectomy: a prospective randomized study. J Neurosurg Spine. 2005;2(3):271-278.
- Carragee EJ, Spinnickie AO, Alamin TF, Paragioudakis S. A prospective controlled study of limited Versus subtotal posterior discectomy: Short-term outcomes in patients with herniated lumbar intervertebral discs and large posterior anular defect. Spine (Phila Pa 1976). 2006;31(6):653-657.
- Kast E, Mohr K, Richter H-P, Börm W. Results of simple fragment excision in lumbar disc surgery. Orthopade. 2005;34(9):931-937
- Schick U, Elhabony R. Prospective comparative study of lumbar sequestrectomy and microdiscectomy. Minim Invasive Neurosurg. 2009;52(4):180-185.
- Boyaci S, Aksoy K. Long-term clinical outcome of the lumbar microdiscectomy and fragmentectomy: A prospective study. Neurosurg Q. 2016;26(2):109-115
- Barth M, Weiss C, Thomé C. Two-year outcome after lumbar microdiscectomy versus microscopic sequestrectomy - Part 1: Evaluation of clinical outcome. Spine (Phila Pa 1976). 2008;33(3):265-272.
There are 30 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Surgical Science Research Articles |
| Authors | |
| Publication Date | September 30, 2019 |
| Acceptance Date | September 25, 2019 |
| Published in Issue | Year 2019Volume: 41 Issue: 3 |