Minimally Invasive Lumbar Discectomy in Obese Patients

Cole, John S.; Jackson, Thad

doi:10.1227/01.neu.0000290900.23190.c9

Cited by 71 publications

(48 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Cole performed minimally invasive lumbar discectomies in 32 obese patients and reported incidental durotomies as the most common complication (9.4%). He attributed this to the greater working distance in overweight patients [21]. In contrast, we registered no significant difference in the occurrence of dural tears in our 3 BMI groups.…”

Section: Discussioncontrasting

confidence: 66%

See 1 more Smart Citation

Perioperative morbidity and complications in minimal access surgery techniques in obese patients with degenerative lumbar disease

et al. 2011

View full text Add to dashboard Cite

The medical profession is increasingly confronted with the epidemic phenomenon of obesity. Its impact on spine surgery is not quite clear. Published data concerning the use of minimally invasive surgery (MIS) in the spine among obese patients is scarce. The purpose of the present retrospective study was to evaluate perioperative as well as postoperative complication rates in MIS fusion of the lumbar spine in obese, overweight and normal patients classified according to their body mass index. Lumbar MIS fusion was performed by means of TLIF procedures and/or posterolateral fusion alone. A laminotomy was performed in patients with spinal stenosis. Of 72 patients, 39 underwent additional laminotomy for spinal stenosis. No differences were registered in respect of the numbers of fused segments or cages. Any harmful event occurring peri-or postoperatively was noted and included in the statistical analysis. No infection at the site of surgery or severe wound healing disorder was encountered. We registered no difference in blood loss, drainage, or the length of the hospital stay between the three BMI groups.We also observed no difference in complication rates between the three groups. This study confirms the low soft tissue damage of minimal access surgery techniques, which is an important type of surgery in obese patients. The smaller approach helps to minimize infections and wound healing disorders. Moreover, deeper regions of wounds are clearly visualized with the aid of tubular retractors.

show abstract

Section: Discussioncontrasting

confidence: 66%

“…Cole [21], using a similar tubular retractor system as in our study, assessed patient outcomes and complication rates after minimally invasive lumbar microdiscectomy in 32 obese patients with a body mass index of 30 or more, and encountered no infectious complications in the study population.…”

Section: Discussionmentioning

confidence: 99%

Perioperative morbidity and complications in minimal access surgery techniques in obese patients with degenerative lumbar disease

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Most of the published literature is on lumbar discectomy complications, such as postoperative wound hematoma, neuronal injury (including postoperative dysethesia), recurrent herniation, postoperative instability, wrong level of exposure, arachnoiditis, infection, incidental durotomy (including its long term sequelae), and pseudomeningoceles 1,2,5,9,18,26,35,[38][39][40]47,49,51,53,54) . In addition, there have been case reports of rare complications after lumbar discectomy, such as development of an arteriovenous fistula, major vessel injury, epidural fibrosis, ureteral injury, compartment syndrome with acute renal failure, iliac artery injury, intradural disc migration, bowel injury, septicemia, symptomatic pneumorachis, instrument failure, postoperative radicular neuroma, Ogilvie's syndrome, and reflex sympathetic dystrophy 3,4,10,12,13,[15][16][17]19,21,22,34,36,37,41,44,45,48,52) .…”

Section: Discussionmentioning

confidence: 99%

Symptomatic Post-Discectomy Pseudocyst after Endoscopic Lumbar Discectomy

Kang

Park

2011

J Korean Neurosurg Soc

View full text Add to dashboard Cite

Objective : The objectives of this study were to determine the frequency of symptomatic postdiscectomy pseudocyst (PP) after endoscopic discectomy and to compare the results of surgical and conservative management of them. Methods : Initial study participants were 1,503 cases (1,406 patients) receiving endoscopic lumbar discectomy by 23-member board of neurosurgeons from March 2003 to October 2008. All patients' postoperative magnetic resonance imaging (MRI) scans were evaluated. On the postoperative MRI, cystic lesion of T2W high and T1W low at discectomy site was regarded as PP. Reviews of medical records and radiological findings were done. The PP patients were divided into two groups, surgical and conservative management by treatment modality after PP detection. We compared the results of the two groups using the visual analogue scale (VAS) for low back pain (LBP), VAS for leg pain (LP) and the Oswestry disability index (ODI). Results : Among 1,503 cases of all male soldiers, the MRIs showed that pseudocysts formed in 15 patients, about 1.0% of the initial cases. The mean postoperative interval from surgery to PP detection was 53.7 days. Interlaminar approach was correlated with PP formation compared with transforaminal approach (p=0.001). The mean VAS for LBP and LP in the surgical group improved from 6.5 and 4.8 to 2.0 and 2.3, respectively. The mean VAS for LBP and LP in the conservative group improved from 4.4 and 4.4 to 3.9 and 2.3, respectively. There was no difference in treatment outcome between surgical and conservative management of symptomatic PP. Conclusion : Although this study was done in limited environment, symptomatic PP was detected at two months' postoperative period in about 1% of cases. Interlaminar approach seems to be more related with PP compared with transforaminal approach.

show abstract

“…Cole et al [20] в ретроспективном анализе данных 32 человек с ИМТ более 30 кг/м 2 , оперированных мини-инвазивным методом, сообщают об удовлетворительных клинических результатах, достигнутых у всех опе-рированных, за исключением одно-го пациента, которому впоследствии потребовалась повторная операция. Боль в нижних конечностях сошла на нет или же оставалась минималь-ной.…”

unclassified

“…Авторы делают вывод, что мини-инвазив-ное вмешательство является мето-дом выбора в этой популяции людей. Минимальная травматизация тканей, минимальный риск послеоперацион-ных осложнений являются основными преимуществами данного метода [20]. Однако авторы не указывают, каким именно из минимально-инвазивных методов были выполнены оператив-ные вмешательства: была ли это стан-дартная микродискэктомия по Caspar или эндоскопическая дискэктомия, осуществлялся ли доступ через позво-ночный канал или же он оставался интактным, проводилась ли дискэк-томия или только секвестрэктомия.…”

unclassified