Patient Selection for Lumbar Laminectomy and Discectomy with a Revised Objective Rating System

Herron, Larry D.; Turner, Judith A.

doi:10.1097/00003086-198510000-00019

Cited by 63 publications

(42 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The fact that neurological deficit may persist in patients with a good outcome corresponds well to previous electromyographic investigations (Knutsson 1961), and might be related to intraneural damage. Previously, better surgical results have been described in patients with neurological deficits (sensory and motor weakness but not reflex asymmetry) preoperatively (Herron and Turner 1985) whereas no such correlation was seen in our series; patients without a preoperative neurological deficit fared as well as those with it in the postoperative course regarding pain relief. The inferior results in patients without neurological deficits previously demonstrated may reflect patients with negative explorations or with minor disc disease in eras of less precise neuroradiological techniques.…”

Section: Discussioncontrasting

confidence: 88%

Neurologic signs in lumbar disc herniation: Preoperative affliction and postoperative recovery in 150 cases

Jönsson

Strömqvist

1996

Acta Orthopaedica Scandinavica

View full text Add to dashboard Cite

Section: Discussioncontrasting

confidence: 88%

Neurologic signs in lumbar disc herniation: Preoperative affliction and postoperative recovery in 150 cases

Jönsson

Strömqvist

1996

Acta Orthopaedica Scandinavica

View full text Add to dashboard Cite

“…The efficacy of lumbar disc herniation treatment is dependent on careful clinical and radiological patient selection [9,21]. There are familial [17,26], psychological [24], social [4], and physical [1,8] predisposing factors involved with lumbar disc herniation, and candidates for surgery must be carefully selected with those factors in mind.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of standard nucleotomy for lumbar disc herniation using the Love method: results of follow-up studies after more than 10 years

et al. 2004

View full text Add to dashboard Cite

IntroductionA nucleotomy following Love's method [14] had been the standard treatment until recently for the care of lumbar disc herniation when nonoperative treatments had failed. However, there are few known reports of long-term follow-up results of a standard lumbar nucleotomy [3,7,16]. Recently, various minimally invasive alternatives have been offered for the management of lumbar disc disease [13,18]. Good results for microsurgical discectomy [19,25], percutaneous nucleotomy [20], and percutaneous laser-assisted discectomy [2] have all been reported. Recent evidence has suggested that complications from the use of these techniques may worsen the neurological status and back pain, because of wrong indications and inexperience [6,22]. We believe that a reevaluation of the simple and conventional standard nucleotomy is needed. Materials and methodsA total of 76 consecutive patients (59 males and 17 females) who underwent a standard lumbar nucleotomy after Love [14] from Abstract A retrospective analysis of long-term follow-up results more than 10 years after a standard nucleotomy for lumbar disc herniation with the Love method was done to determine the effectiveness of this procedure. Nucleotomy according to Love was the standard treatment for lumbar disc herniation before the various minimally invasive alternatives were recently introduced. Without long-term follow-up analysis of Love operations, evidence-based evaluation of those new methods is impossible. We believe that the standard nucleotomy procedure should now be evaluated precisely. In this study we present a comparison of 1-year follow-up results to the results more than 10 years after lumbar nucleotomy. Seventy-six consecutive patients who had undergone lumbar nucleotomy were identified. It was possible to assess 54 (71.1%) of the cases more than 10 years after surgery. The initial and final outcomes were assessed using the MacNab classification and the Japanese Orthopaedic Association (JOA) score. With the MacNab classification a successful outcome 1 year after surgery was achieved in 87.0% of the cases. At the final follow-up, this result was reduced to 74.1%. Seven patients required a second operation and patients under 21 years of age were at risk for reoperation. Patient overall satisfaction with the results of the standard nucleotomy was high. The disc height of the operation site significantly decreased after surgery; nevertheless, this did not affect the clinical outcome. A standard lumbar nucleotomy according to Love is a safe and reliable method of treating selected patients with lumbar disc herniations.

show abstract

“…Other studies, on the contrary, reported that a positive Lasègue sign in the preoperative period is a positive predictor of outcome. [29][30][31] The result of our study indicates that patients with a positive or negative Lasègue sign preoperatively appear to have the same results in pain, disability and quality of life in the postoperative period. Also, the analyses of discrimination capacity of that sign in predicting changes in HRQoL measures one-year postoperatively did not demonstrate good association either alone or in combination with the other clinical signs of nerve root impairment.…”

Section: Totalmentioning

confidence: 64%

“…18,27 Despite these findings, there is still doubt concerning the prognostic importance of this sign in the preoperative period. 12,29,30 Junge et al 12 in a prospective study with 12 months follow-up did not observe that a positive Lasègue sign in the preoperative period was not related to good or bad surgical outcomes. These findings are supported by Woergten et al 26 , who found that a positive SLR test (up to 30 degrees) was not predictive of a good outcome 3 and 24 months postoperatively.…”

Section: Totalmentioning

confidence: 93%

Is the lasègue sign a predictor of outcome in lumbar disc herniation surgery?

Falavigna

Righesso²,

Teles

et al. 2013

Coluna/Columna

View full text Add to dashboard Cite

Objective: Evaluate the predictive value of the Lasègue sign on self-reported quality of life measures (HRQoL) in patients who undergo microdiscectomy. Methods: 95 patients with clinical and radiological diagnosis of LDH who underwent microdiscectomy were included. The patients were assessed by a neurological examination and answered validated instruments to assess pain, disability, quality of life, and mood disorder in the preoperative period, and 1, 6 and 12 months after surgery. Results: Preoperative Lasègue sign was identified in 56.8% (n=54/95) of the cases. There was no difference between the groups in the preoperative period regarding HRQoL. At one year follow-up no statistically significant difference in HRQoL was observed in the Lasègue group. The discrimination capacity of the preoperative Lasègue sign to determinate variations in HRQoL outcomes one year postoperatively was low. Conclusion: Lasègue sign is not a good predictor of outcome after microdiscectomy for LDH.Keywords: Intervertebral disc displacement; Quality of life; Prognosis; Spine/surgery. RESUMO Objetivo: Avaliar o valor preditivo do Sinal de Lasègue em medidas de qualidade de vida (HRQoL) em pacientes submetidos a microdiscectomia. Métodos: 95 pacientes com diagnóstico clínico e radiológico de HDL submetidos à microdiscectomia foram incluídos. Os pacientes foram avaliados por exame neurológico e responderam instrumentos validados para medir dor, incapacidade, qualidade de vida e transtornos do humor no período pré-operatório e 1, 6 e 12 meses após a cirurgia. Resultados: O sinal de Lasègue no pré-operatório foi identificado em 56,8% (n = 54/95) dos casos. Não houve diferença entre os grupos no pré-operatório em relação à HRQoL. Em um ano de pós-operatório não foi observada diferença estatística com relação à HRQoL no grupo com Lasègue. A capacidade de discriminação do Sinal de Lasègue pré-operatório para determinar variações na

show abstract

Patient Selection for Lumbar Laminectomy and Discectomy with a Revised Objective Rating System

Cited by 63 publications

References 0 publications

Neurologic signs in lumbar disc herniation: Preoperative affliction and postoperative recovery in 150 cases

Neurologic signs in lumbar disc herniation: Preoperative affliction and postoperative recovery in 150 cases

Evaluation of standard nucleotomy for lumbar disc herniation using the Love method: results of follow-up studies after more than 10 years

Is the lasègue sign a predictor of outcome in lumbar disc herniation surgery?

Contact Info

Product

Resources

About