20 years follow-up after the first microsurgical lumbar discectomies in Iceland

Jensdottir, Margret; Gudmundsson, K.; Hannesson, B.; Gudmundsson, Gardar

doi:10.1007/s00701-006-1068-y

Cited by 18 publications

(13 citation statements)

References 29 publications

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“…Indeed, clinical studies have established that there is an unclear relationship between radiological signs of LDH and degree of sciatica or other clinical symptoms 15 . In keeping with the main indication for LDHsurg 13 20 ; the neuropathic and painful symptoms of sciatica, we find of interest that height is inversely correlated with peripheral nerve conduction velocity 42 and has been shown to increase risk of peripheral sensory neuropathy in diabetes 43 , peripheral insensate neuropathy 44 , HIV neuropathy 45 and post-mastectomy neuropathic pain syndrome 46 . While the pathogenesis behind the relationship between height and neuropathic pain is unclear, increased height in humans is known to associate with increased axonal length and greater axon surface area 47 .…”

Section: Discussionmentioning

confidence: 57%

“…Furthermore, about a third of symptomatic LDH resolve within weeks or months regardless of intervention 13 16 17 with only a fraction (5–10%) leading to persistent sciatica or radiculopathy requiring surgery 18 19 . Microdiscectomy, a minimally invasive spinal surgery for removal of herniated lumbar disc tissue, is indicated only for individuals with severe, progressive and persistent sciatica symptoms that are consistent with location of the radiologically confirmed herniated disc 13 20 . These surgical criteria, therefore, define a clear and specific phenotype of sciatica secondary to LDH pathology that we here show associates strongly with a sequence variant at 8q24.21 between GSDMC and CCDC26.…”

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confidence: 99%

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Sequence variant at 8q24.21 associates with sciatica caused by lumbar disc herniation

et al. 2017

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Lumbar disc herniation (LDH) is common and often debilitating. Microdiscectomy of herniated lumbar discs (LDHsurg) is performed on the most severe cases to resolve the resulting sciatica. Here we perform a genome-wide association study on 4,748 LDHsurg cases and 282,590 population controls and discover 37 highly correlated markers associating with LDHsurg at 8q24.21 (between CCDC26 and GSDMC), represented by rs6651255[C] (OR=0.81; P=5.6 × 10−12) with a stronger effect among younger patients than older. As rs6651255[C] also associates with height, we performed a Mendelian randomization analysis using height polygenic risk scores as instruments to estimate the effect of height on LDHsurg risk, and found that the marker's association with LDHsurg is much greater than predicted by its effect on height. In light of presented findings, we speculate that the effect of rs6651255 on LDHsurg is driven by susceptibility to developing severe and persistent sciatica upon LDH.

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Section: Discussionmentioning

confidence: 57%

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confidence: 99%

Sequence variant at 8q24.21 associates with sciatica caused by lumbar disc herniation

et al. 2017

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“…28,30,32,41,[46][47][48] The recurrence rate in our study was 2.6%, which is lower than the rates reported in the literature (7.1 to 12.7%). [49][50][51][52][53] The rate of residual postoperative complaints in our study population was 71.1%. Residual back pain occurred in 43.3% of cases, which was higher than one study that reported a 17% rate for backache at the time of follow-up.…”

Section: Discussion Outcomementioning

confidence: 99%

Lumbar Disk Herniation Surgery: Outcome and Predictors

Sedighi

Haghnegahdar

2014

Global Spine Journal

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Study Design A retrospective cohort study. Objectives To determine the outcome and any differences in the clinical results of three different surgical methods for lumbar disk herniation and to assess the effect of factors that could predict the outcome of surgery. Methods We evaluated 148 patients who had operations for lumbar disk herniation from March 2006 to March 2011 using three different surgical techniques (laminectomy, microscopically assisted percutaneous nucleotomy, and spinous process osteotomy) by using Japanese Orthopaedic Association (JOA) Back Pain Evaluation Questionnaire, Resumption of Activities of Daily Living scale and changes of visual analog scale (VAS) for low back pain and radicular pain. Our study questionnaire addressed patient subjective satisfaction with the operation, residual complaints, and job resumption. Data were analyzed with SPSS version 16.0 (SPSS, Inc., Chicago, Illinois, United States). Statistical significance was set at 0.05. For statistical analysis, chi-square test, Mann-Whitney U test, Kruskal-Wallis test, and repeated measure analysis were performed. For determining the confounding factors, univariate analysis by chi-square test was used and followed by logistic regression analysis. Results Ninety-four percent of our patients were satisfied with the results of their surgeries. VAS documented an overall 93.3% success rate for reduction of radicular pain. Laminectomy resulted in better outcome in terms of JOA Back Pain Evaluation Questionnaire. The outcome of surgery did not significantly differ by age, sex, level of education, preoperative VAS for back, preoperative VAS for radicular pain, return to previous job, or level of herniation. Conclusion Surgery for lumbar disk herniation is effective in reducing radicular pain (93.4%). All three surgical approaches resulted in significant decrease in preoperative radicular pain and low back pain, but intergroup variation in the outcome was not achieved. As indicated by JOA Back Pain Evaluation Questionnaire–Low Back Pain (JOABPQ-LBP) and lumbar function functional scores, laminectomy achieved significantly better outcome compared with other methods. It is worth mentioning that relief of radicular pain was associated with subjective satisfaction with the surgery among our study population. Predictive factors for ineffective surgical treatment for lumbar disk herniation were female sex and negative preoperative straight leg raising. Age, level of education, and preoperative VAS for low back pain were other factors that showed prediction power.

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“…Operations for lumbar disc herniation are numerous [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 ] and have been performed since the 1934 publi- cation by Mixter and Barr [ 33 ]. Indeed, operations for lumbar disc herniation are the most frequently done neurosurgical procedures.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Results of Various Operations for Lumbar Disc Herniation: Analysis of over 39,000 Patients

Dohrmann

Mansour²

2015

Med Princ Pract

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Objective: To determine the long-term follow-up of the various operations for lumbar disc herniation in a large patient population. Subjects and Methods: Patients who had operations for lumbar disc herniation (microdiscectomy, endoscopic microdiscectomy and the ‘classical operation', i.e. laminectomy/laminotomy with discectomy) were collected from the world literature. Patients who had follow-ups for at least 2 years were analyzed relative to the outcome. The outcome was graded by the patients themselves, and the operative groups were compared to one another. Results: 39,048 patients collected from the world literature had had lumbar disc operations for disc herniations. The mean follow-up period was 6.1 years, and 30,809 (78.9%) patients reported good/excellent results. Microdiscectomy was performed on 3,400 (8.7%) patients. The mean follow-up was 4.1 years with 2,866 (84.3%) good/excellent results, while 1,101 (3.6%) patients had endoscopic microdiscectomy. There, the mean follow-up was 2.9 years with 845 (79.5%) good/excellent results. The classical operation was performed on 34,547 (88.5%) patients with a mean follow-up period of 6.3 years, and 27,050 (78.3%) patients had good/excellent results. These results mirror those with discectomy and the placement of prosthetic discs. Conclusions: The analysis of 39,048 patients with various operations for lumbar disc herniation revealed the same pattern of long-term results. Patients who had microdiscectomy, endoscopic microdiscectomy or the classical operation (laminectomy/laminotomy with discectomy) all had approximately 79% good/excellent results. None of the operative procedures gave a different outcome.

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20 years follow-up after the first microsurgical lumbar discectomies in Iceland

Abstract: Outcome was very good with 92.0% return to work and 91.1% patient satisfaction. The recurrence rate was 12.7% with a substantial number of cases occurring 10-20 years after operation. To conclude, microsurgical discectomies maintain a high success rate in the long-term.

Cited by 18 publications

References 29 publications

Sequence variant at 8q24.21 associates with sciatica caused by lumbar disc herniation

Sequence variant at 8q24.21 associates with sciatica caused by lumbar disc herniation

Lumbar Disk Herniation Surgery: Outcome and Predictors

Long-Term Results of Various Operations for Lumbar Disc Herniation: Analysis of over 39,000 Patients

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