ISSN: 1859 - 2872
Comparing the clinical outcome and early postoperative analgesic consumption of the lumbar discectomy: Open subperiosteal discectomy versus transmuscular microdiscectomy
Main Article Content
Keywords
Abstract
Objective: To determine the clinical outcome and early postoperative analgesic consumption of two lumbar disc herniation surgical techniques: Conventional subperiosteal discectomy and transmuscular microdiscectomy. Subject and method: Retrospectively. This study included lateral or paracentral single-level lumbar disc herniation underwent surgical treatment in Neurosurgery Department of 108 Military Central Hospital from December 2016 to February 2019. The patients were divided in to two groups: Group I (63 patients) underwent the conventional open subperiosteal discectomy (OSD) and group II (42 patients) underwent the transmuscular microdiscectomy (TMD). The clinical outcomes were assessed by ODI, VAS for back and leg pain score. The early postoperative analgesic consumption was scored by the WHO 3-class protocol. A p<0.05 was considered to indicate significance. Result: A significant improvement of the postoperative ODI, VAS score were observed in both groups. However, there was no difference about clinical outcome between two groups. The postsurgical analgesic consumption in TMD goup was significantly less than OSD group (4.7 points vs 2.6 points, p=0.03). Conclusion: The transmuscular microdiscectomy had equivalent clinical outcome when compare with conventional open subperiosteal discectomy. However, the early postoperative analgesic consumption in transmuscular microdiscectomy group was significantly less than open subperiosteal discectomy group. Therefore, the transmuscular microdiscectomy is a less invasive technique for the open subperiosteal discectomy
Article Details
References
2. Katayama Y, Matsuyama Y, Yoshihara H, Sakai Y, Nakamura H, Nakashima S et al (2006) Comparison of surgical outcomes between macrodiscectomy and microdiscectomy for lumbar disc herniation: A prospective randomized study with surgery performed by the same spine surgeon. J Spinal Disord Tech 19(5): 344-347.
3. Veresciagina K, Spakauskas B, Ambrozaitis KV (2010) Clinical outcomes of patients with lumbar disc herniation, selected for one-level open-discectomy and microdiscectomy. Eur Spine J 19(9): 1450-1458.
4. Schick U, Dohnert J, Richter A (2002) Microendoscopic lumbar discectomy versus open surgery: An intraoperative EMG study. Eur Spine J 11(1): 20-26.
5. Kim DY, Lee SH, Chung SK, Lee HY (2005) Comparison of multifidus muscle atrophy and trunk extension muscle strength: Percutaneous versus open pedicle screw fixation. Spine 30(1): 123-129.
6. Brock M, Kunkel P, Papavero L (2008) Lumbar microdiscectomy: Subperiosteal versus transmuscular approach and influence on the early postoperative analgesic consumption. Eur Spine J 17: 518-522.
7. Franke J, Greiner-Perth R, Boehm H, Mahlfeld K, Grasshoff H, Allam Y et al (2009) Comparison of a minimally invasive procedure versus standard microscopic discotomy: A prospective randomised controlled clinical trial. Eur Spine J 18(7): 992-1000.
8. Tachibana T, Maruo K, Fumihiro Arizumi (2017) Preservation of paraspinal muscle after transmuscular approach using a tubular retractor for lumbar decompression surgery. Interdisciplinary Neurosurgery: Advanced Techniques and Case Management 9: 85-88.
9. Park BS, Kwon YJ, Won YS (2010) Minimally invasive muscle sparing transmuscular microdiscectomy: Technique and comparison with conventional subperiosteal microdiscectomy during the early postoperative period. J Korean Neurosurg Soc 48: 225-229.
10. Kim YB, Hyun SJ (2007) Clinical applications of the tubular retractor on spinal disorders. J Korean Neurosurg Soc 42: 245-250.
11. Arts MP, Brand R, van den Akker ME, Koes BW, Bartels RH, Tan WF et al (2011) Tubular diskectomy vs conventional microdiskectomy for the treatment of lumbar disk herniation: 2-year results of a double-blind randomized controlled trial. Neurosurgery 69(1): 135-144.
12. Amin RM, Andrade NS, Neuman BJ (2017) Lumbar disc herniation. Curr Rev Musculoskelet Med 10: 507-516.
Article Sidebar
