Benign Neurological Recovery with Low Recurrence and Low Peridural Fibrosis Rate in Pediatric Disc Herniations after Lumbar Microdiscectomy

Çelik, Suat Erol; Göksu, Kamber; Emir, Canan Bolcu

doi:10.1159/000338982

Cited by 12 publications

(3 citation statements)

References 38 publications

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“…2,3,9,[17][18][19]21,25,26,28,33,36,[41][42][43]45,49,[52][53][54][56][57][58]61 MED techniques employ a longitudinal paramedian incision through which a tubular retractor is placed and visualization is achieved through an endoscope. 2,6,10,13,19,24,25,29,36,46,51,53,57,60,62,64 Percutaneous discectomy entails placing a sheath directly into the disc space via a transforaminal approach, extraforaminal approach, or interlaminar approach and then using a suction/debrider or chemical injection to remove the disc.…”

Section: Data Collectionmentioning

confidence: 99%

Lumbar microdiscectomy complication rates: a systematic review and meta-analysis

Shriver¹,

Xie

Tye³

et al. 2015

FOC

126

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OBJECT Lumbar microdiscectomy and its various minimally invasive surgical techniques are seeing increasing popularity, but a systematic review of their associated complications has yet to be performed. The authors sought to identify all prospective clinical studies reporting complications associated with lumbar open microdiscectomy, microendoscopic discectomy (MED), and percutaneous microdiscectomy. METHODS The authors conducted MEDLINE, Scopus, Web of Science, and Embase database searches for randomized controlled trials and prospective cohort studies reporting complications associated with open, microendoscopic, or percutaneous lumbar microdiscectomy. Studies with fewer than 10 patients and published before 1990 were excluded. Overall and interstudy median complication rates were calculated for each surgical technique. The authors also performed a meta-analysis of the reported complications to assess statistical significance across the various surgical techniques. RESULTS Of 9504 articles retrieved from the databases, 42 met inclusion criteria. Most studies screened were retrospective case series, limiting the number of studies that could be included. A total of 9 complication types were identified in the included studies, and these were analyzed across each of the surgical techniques. The rates of any complication across the included studies were 12.5%, 13.3%, and 10.8% for open, MED, and percutaneous microdiscectomy, respectively. New or worsening neurological deficit arose in 1.3%, 3.0%, and 1.6% of patients, while direct nerve root injury occurred at rates of 2.6%, 0.9%, and 1.1%, respectively. Hematoma was reported at rates of 0.5%, 1.2%, and 0.6%, respectively. Wound complications (infection, dehiscence, orseroma) occurred at rates of 2.1%, 1.2%, and 0.5%, respectively. The rates of recurrent disc complications were 4.4%, 3.1%, and 3.9%, while reoperation was indicated in 7.1%, 3.7%, and 10.2% of operations, respectively. Meta-analysis calculations revealed a statistically significant higher rate of intraoperative nerve root injury following percutaneous procedures relative to MED. No other significant differences were found. CONCLUSIONS This review highlights complication rates among various microdiscectomy techniques, which likely reflect real-world practice and conceptualization of complications among physicians. This investigation sets the framework for further discussions regarding microdiscectomy options and their associated complications during the informed consent process.

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Section: Data Collectionmentioning

confidence: 99%

Lumbar microdiscectomy complication rates: a systematic review and meta-analysis

Shriver¹,

Xie

Tye³

et al. 2015

FOC

126

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“…7 Regarding outcome, in a prospective study comparing children with adults, the pediatric LDH group was postoperatively better than the adult group both clinically and radiologically. 8 Cystic fibrosis is one of the most commonly inherited autosomal recessive disorders among caucasians. With the improved survival rates, chronic pain becomes a common problem in patients with this disorder.…”

Section: Discussionmentioning

confidence: 99%

Lumbar disc herniation in a child with cystic fibrosis. Case report

2014

Arch Argent Pediat

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We report a case of child with cystic fibrosis and lumbar disc herniation. An 8-year-old boy presented with low back pain that exacerbated on coughing, sitting, walking, or bending and diminished when lying down. The straight leg raising test was positive when the right leg was lifted at 60 degrees. Crossed leg raising test was negative. Lumbar MRI revealed a L5-S1central disc protrusion. Conservative treatment was not effective and the patient underwent surgery. Postoperatively the patient experienced regression of the pain. To the best of our knowledge this is the first reported case of lumbar disc herniation in a child with cystic fibrosis. Although this case might be coincidental, thorough investigation of back pain, which is frequent in patients with cystic fibrosis, should be performed.

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“…7 Con respecto a la evolución, en un estudio prospectivo que compara niños y adultos, el grupo pediátrico tuvo un mejor posoperatorio, tanto desde el punto de vista clínico como radiológico. 8 La fibrosis quística es una de las enfermedades hereditarias autosómicas recesivas más frecuentes entre los caucásicos. Con la mejoría de los índices de supervivencia, el dolor crónico se ha convertido en un problema común en los pacientes con esta enfermedad.…”

Section: Discussionunclassified