Reoperation Rates of Microendoscopic Discectomy Compared With Conventional Open Lumbar Discectomy: A Large-database Study

Abstract

Background Microendoscopic discectomy for lumbar disc herniation has been shown to be as effective as traditional microdiscectomy or open discectomy in terms of clinical outcomes such as pain relief, and it is less invasive. Nevertheless, the reoperation rate for microendoscopic discectomy compared with microdiscectomy or open discectomy remains unclear, possibly due to difficulties in conducting follow-up of sufficient duration and in obtaining information about reoperation in other facilities.Questions/purposes (1) What is the rate of reoperation after microendoscopic discectomy for primary lumbar disc herniation on a large scale at a median of 4 years postoperatively? (2) Is there any difference in revision rate at a median of 4 years and within 90 days postoperatively based on surgical method? Methods We conducted a retrospective, comparative study of adult patients who underwent microendoscopic discectomy or microdiscectomy or open discectomy for One of the authors (KK) certifies receipt of personal payments or benefits, during the study period, in an amount of USD 100,001 to USD

CORR Insights®: Reoperation Rates of Microendoscopic Discectomy Compared With Conventional Open Lumbar Discectomy: A Large-database Study

“…But it’s a start. The present study by Masuda et al [7] is the first step in this direction; they compared microendoscopic discectomy against open discectomy and traditional microdiscectomy and found that the risk of reoperation was higher among patients who underwent microendoscopic discectomy than among patients who underwent an open discectomy or traditional microdiscectomy at a median follow-up of 4 years after surgery in a large group of patients. Based on this finding, surgeons should make an educated decision about which technique to use and inform their patients accordingly.…”

Cardiovascular Safety of Atomoxetine and Methylphenidate in Patients With Attention-Deficit/Hyperactivity Disorder in Japan: A Self-Controlled Case Series Study

“…These diagnoses, prescriptions, and procedures are coded using the International Classification of Diseases, Tenth Revision (ICD-10) codes, the Anatomical Therapeutic Chemical (ATC) codes together with the Japan-specific YJ (Yakka Joho) codes (code according to the National Health Insurance Drug List), and the Japanese procedure codes. The advantage of the JMDC database is its ability to track an individual’s medical information across different healthcare facilities under the same health insurance, making it widely used for epidemiology studies in Japan (Fukasawa et al, 2023; Masuda et al, 2023; S. Yoshida et al, 2022).…”

CORR Insights®: Are Dental Procedures Associated With Pyogenic Vertebral Osteomyelitis?

“…In this retrospective, comparative study of a claims database designed to replicate a case-crossover design [9], which is published in this issue of Clinical Orthopaedics and Related Research ® , the authors isolated patients with hospital-coded pyogenic vertebral osteomyelitis and examined their histories of dental procedures and antibiotic prescriptions. Masuda et al [9] found that dental procedures were not associated with infection, prophylactic antibiotics did not reduce infection risk, and rather paradoxically, the authors found that patients who were not prescribed antibiotics before dental procedures had substantially lower odds of developing pyogenic vertebral osteomyelitis. Based on these discoveries, surgeons might more carefully examine their own prescribing practices.…”

“…Although prophylactic antibiotics may prevent infection generally, in patients with a high prevalence of risk factors, Masuda et al [9] found that a claims history of an antibiotic prescription near the time of the proposed inciting event did not change the odds of infection. A similar database study could be performed in a high-risk patient subset who underwent arthroplasty.…”