Surgery for Lumbar Disc Prolapse: The Decision is More Important than the Incision

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Journal of Clinical Orthopaedics | Vol 9 | Issue 2 |  July-December 2024 | page: 17-21 | Shrinivas Prabhu, Gautam Zaveri

DOI: https://doi.org/10.13107/jcorth.2024.v09i02.648

Submitted Date: 13 Sep 2024, Review Date: 22 Sep 2024, Accepted Date: 28 Nov 2024 & Published Date: 10 Dec 2024

Author: Shrinivas Prabhu [1], Gautam Zaveri [2]

[1] Department of Orthopaedics, MGMIHS, Navi Mumbai, Maharashtra, India
[2] Department of Spine Surgery, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India

Address of Correspondence

Dr. Gautam Zaveri,
Department of Spine Surgery, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India
E-mail: gautamzaveri1969@gmail.com

Abstract

The common techniques of discectomy for a posterolateral lumbar disc herniation include conventional open discectomy, microlumbar discectomy, tubular microdiscectomy, and endoscopic discectomy. All these techniques involve an interlaminar fenestration for accessing the spinal canal, decompressing the neural elements, and performing the discectomy with the goal of relieving radicular leg pain and improving function. The current review aims to briefly outline the evolution of lumbar discectomy over the last century, examine the pros and cons, and compare the short-term and long-term clinical outcomes of the common techniques of lumbar discectomy. While no single approach may be universally superior to the other, surgical selection tailored to patient-specific factors and surgeons’ experience with a technique helps to optimize clinical outcomes.
Keywords: Lumbar disc prolapse, microlumbar discectomy, tubular discectomy, endoscopic discectomy

References

1. Dohrmann GJ, Mansour N. Long-term results of various operations for lumbar disc herniation: Analysis of over 39,000 patients. Med Princ Pract 2015;24:285-90.
2. Gotfryd A, Avanzi O. A systematic review of randomised clinical trials using posterior discectomy to treat lumbar disc herniations. Int Orthop 2009;33:11-7.
3. He J, Xiao S, Wu Z, Yuan Z. Microendoscopic discectomy versus open discectomy for lumbar disc herniation: A meta-analysis. Eur Spine J 2016;25:1373-81.
4. Brock M, Kunkel P, Papavero L. Lumbar microdiscectomy: Subperiosteal versus transmuscular approach and influence on the early postoperative analgesic consumption. Eur Spine J 2008;17:518-22.
5. Teles P, Pereira P, Silva C, Vaz R, Santos Silva P. Minimally invasive treatment for lumbar disc herniation: A matched comparison between tubular microdiscectomy and percutaneous endoscopic lumbar discectomy. Cureus 2024;16:e57589.
6. Liu X, Yuan S, Tian Y, Wang L, Gong L, Zheng Y, et al. Comparison of percutaneous endoscopic transforaminal discectomy, microendoscopic discectomy, and microdiscectomy for symptomatic lumbar disc herniation: Minimum 2-year follow-up results. J Neurosurg Spine 2018;28:317-25.
7. Giardi FP, Cammisa FP Jr., Huang RC, Parvataneni HK, Tsairis P. Improvement of preoperative foot drop after lumbar surgery. J Spinal Disord Tech 2002;15:490-4.
8. Postacchini F, Giannicola G, Cinnoti G. Recovery of motor deficits after microdiscectomy for lumbar disc herniation. J Bone Joint Surg Br 2002;84:1040-5.
9. Aono H, Iwasaki M, Ohwada T, Okuda S, Hosono N, Fuji T, et al. Surgical outcome of drop foot caused by degenerative lumbar diseases. Spine (Phila Pa 1976) 2007;32:E262-6.
10. Liu K, Zhu W, Shi J, Jia L, Shi G, Wang Y, et al. Foot drop caused by lumbar degenerative disease: Clinical features, prognostic factors of surgical outcome and clinical stage. PLoS One 2013;8:e80375.
11. Moranjkic M, Ercegovic Z, Hodzic M, Brkic H. Outcome prediction in lumbar disc herniation surgery. Acta Med Sal 2010;39:75-8.
12. Stromqvist F, Ahmad M, Hildingsson C, Jönsson B, Strömqvist B. Gender differences in lumbar disc herniation surgery. Acta Orthop 2008;79:643-9.

 

How to Cite this article: Prabhu S, Zaveri G. Surgery for Lumbar Disc Prolapse: The Decision is More Important than the Incision. Journal of Clinical Orthopaedics July-December 2024;9(2):17-21.

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