Microendoscopic lumbar discectomy with general versus local anesthesia: A systematic review and meta-analysis

Mooney, James; Erickson, Nicholas; Salehani, Arsalaan; Laskay, Nicholas M B; Mahavadi, Anil; Ilyas, Adeel; Mainali, Bipul; Agarwal, Nitin; Godzik, Jakub

doi:10.1016/j.xnsj.2022.100129

Cited by 4 publications

(3 citation statements)

References 53 publications

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“…The PLIF surgeries in the present study were performed under general anaesthesia. Notably, the results after surgery may vary according to anaesthesia type [ 32 , 33 ]. The results of the present study were limited to PLIF under general anaesthesia.…”

Section: Discussionmentioning

confidence: 99%

Back Muscle Mass as a Predictor of Postoperative Complications in Posterior Lumbar Interbody Fusion Surgery

Hong,

Rhee,

Kim

et al. 2023

JCM

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Background: There is a lack of studies on utilising skeletal muscle mass via preoperative lumbar computed tomography or magnetic resonance imaging as a predictor of postoperative complications of posterior lumbar interbody fusion (PLIF) surgery in elderly patients. Methods: Patients aged >65 years who underwent PLIF were enrolled. The sum of the cross-sectional areas of the erector spinae muscles (CSABoth) was presented as the skeletal muscle mass. Postoperative complications were assessed using CSABoth, pulmonary function testing, and prognostic nutritional index (PNI). Results: Patients with postoperative complications showed significantly lower values of CSABoth (median 2266.70 (2239.73–2875.10) mm2 vs. 3060.30 (2749.25–3473.30) mm2, p < 0.001), functional vital capacity, forced expiratory volume at 1 s, and PNI. However, multiple logistic regression analysis identified American Society of Anaesthesiologists Physical Status (ASA PS) I (odds ratio 0.307 (95% confidence interval 0.110–0.852), p = 0.023), ASA PS III (4.033 (1.586–10.254), p = 0.003), CSABoth (0.999 (0.999–1.000), p < 0.001), and postoperative red blood cell (RBC) transfusion (1.603 (1.193–2.152), p = 0.002) as risk factors for postoperative complications after PLIF surgery. Conclusions: CSABoth, ASA PS III, and postoperative RBC transfusion might be used as predictors of postoperative complications after PLIF in patients aged >65 years.

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Section: Discussionmentioning

confidence: 99%

Back Muscle Mass as a Predictor of Postoperative Complications in Posterior Lumbar Interbody Fusion Surgery

Hong,

Rhee,

Kim

et al. 2023

JCM

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“…The precision of ultrasound guidance allows for a less invasive approach which is amendable to being performed using only local anesthesia, thus reducing the risks associated with general or regional anesthesia required for more traditional operative procedures. 19 Reduction in operative time likely further decreases risk. 20 Moreover, there is reduced cost, since less resources and time are required to perform an USG surgery in an outpatient clinical setting compared with a procedure performed in an operating room.…”

mentioning

confidence: 99%

“…USG surgical techniques offer several advantages over open or arthroscopic/endoscopic operative procedures. The precision of ultrasound guidance allows for a less invasive approach which is amendable to being performed using only local anesthesia, thus reducing the risks associated with general or regional anesthesia required for more traditional operative procedures 19 . Reduction in operative time likely further decreases risk 20 .…”

mentioning

confidence: 99%

Three‐Month Complication Rate of Ultrasound‐Guided Soft Tissue Surgical Procedures Across Six Sports Medicine Clinics

Hall,

Kliethermes,

Henning

et al. 2023

J of Ultrasound Medicine

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ObjectivesTo 1) determine the types and frequency of complications within 3 months following ultrasound‐guided surgical procedures, and 2) identify any patient demographics, co‐morbidities, or procedural characteristics that were associated with an increased risk of complications.MethodsA retrospective chart review was performed at six Sports Medicine clinics across the United States. The Clavien‐Dindo classification was used to categorize procedural complications on a 5‐point scale from 1, representing any deviation in post‐procedure care without requiring pharmacological or invasive treatment to 5, representing death. Generalized Estimating Equations for binomial outcomes with a logit link were used to estimate the overall and procedure‐specific 3‐month complication rates.ResultsAmong 1902 patients, 8.1% (n = 154) had diabetes and 6.3% (n = 119) were current smokers. The analysis included 2,369 procedures, which were performed in either the upper extremity (44.1%, n = 1045) or lower extremity (55.2%, n = 1308) regions. The most common procedure was ultrasound‐guided tenotomy (69.9%, n = 1655). Additional procedures included, trigger finger release (13.1%, n = 310), tendon scraping (8.0%, n = 189), carpal tunnel release (5.4%, n = 128), soft tissue release (2.1%, n = 50), and compartment fasciotomy (1.6%, n = 37). Overall, there was a complication rate of 1.2% (n = 29 complications; 95% CI: 0.8–1.7%). Individual procedures had complication rates that ranged from 0 to 2.7%. There were 13 Grade I complications in 13 patients, 12 Grade II complications in 10 patients, 4 Grade III complications in 4 patients, and 0 Grade IV or V complications. No associations between complication risk and any patient demographics (age, sex, BMI), co‐morbidities (diabetes, smoker), or procedure characteristics (type, region) were identified.ConclusionThis retrospective review provides an evidence‐based estimate supporting the low level of risk associated with ultrasound‐guided surgical procedures for patients from a variety of geographical settings who are seeking care at private and academic‐affiliated clinics.

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Comparative analysis of perioperative characteristics and early outcomes in transforaminal endoscopic lumbar diskectomy: general anesthesia versus conscious sedation

et al. 2023

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Microendoscopic lumbar discectomy with general versus local anesthesia: A systematic review and meta-analysis

Cited by 4 publications

References 53 publications

Back Muscle Mass as a Predictor of Postoperative Complications in Posterior Lumbar Interbody Fusion Surgery

Back Muscle Mass as a Predictor of Postoperative Complications in Posterior Lumbar Interbody Fusion Surgery

Three‐Month Complication Rate of Ultrasound‐Guided Soft Tissue Surgical Procedures Across Six Sports Medicine Clinics

Comparative analysis of perioperative characteristics and early outcomes in transforaminal endoscopic lumbar diskectomy: general anesthesia versus conscious sedation

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