The “tract” of history in the treatment of lumbar degenerative disc disease

Chedid, Khalil; Chedid, Mokbel

doi:10.3171/foc.2004.16.1.8

Cited by 22 publications

(20 citation statements)

References 25 publications

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“…First discectomy was done by Oppenheim and Fedre Krause in 1906 though the first publication was done by Mixter and Bar 12. Since then laminectomy, hemilaminectomy and fenestration were introduced and are still being widely practiced world over.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic lumbar discectomy: Experience of first 100 cases

Jhala¹,

Mistry²

2010

IJOO

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Background:Various modalities of treatment from standard discectomy, microdiscectomy, percutaneous discectomy, and transforaminal endoscopic discectomy have been in use for lumbar intervertebral disc prolapse. The access to spine is kept to a minimum without stripping paraspinal muscles minimizing muscle damage by posterior interlaminar endoscopic approach. The aim of this study was to evaluate technical problems, complications, and overall initial results of microendoscopic discectomy.Materials and Methods:First 100 consecutive cases aged 19-65 years operated by microendoscopic dissectomy between August 2002 – December 2005 are reported. All patients with single nerve root lesions including sequestrated or migrated and selected central disc at L4-5 and L5-S1 were included. The patients with bilateral radiculopathy were excluded. All patients had preoperative MRI and first 11 patients had postoperative MRI to check the adequacy of decompression. Diagnostic selective nerve root blocks were done in selective cases to isolate the single root lesion when MRI was inconclusive (n=7). All patients were operated by a single surgeon with the Metrx system (Medtronics). 97 were operated by 18-mm ports, and only three patients were operated by 16-mm ports. Postoperatively, all patients were mobilized as soon as the pain subsided and discharged within 24–48 h postsurgery. Patients were evaluated for technical problems, complications, and overall results by modified Macnab criteria. Patients were followed up at 2, 6, and 12 weeks.Results:The mean follow up was 12 months (range 3 months – 4 years). Open conversion was required in one patient with suspected root damage. Peroperatively single facet removal was done in 5 initial cases. Minor dural punctures occurred in seven cases and root damage in one case. The average surgical time was 70 min (range 25-210 min). Average blood loss was 20-30 ml. Technical difficulties encountered in initial 25 cases were insertion of guide pin, image orientation, peroperative dissection and bleeding problems, and reaching wrong levels suggestive of a definitive learning curve. Postoperative MRI (n=11) showed complete decompression. Overall 91% of patients had good-to-excellent results, with four patients having recurrence of whom three were reoperated. Four patients had postoperative discitis. One of the patients required fusion for discitis and rest were managed conservatively. One patient had root damage to L5 root that had paresthesia in L5 region even on 4 years of follow-up.Conclusion:Microendoscopic discectomy is minimally invasive procedure for discectomy with early encouraging results. Once definite learning curve was over and expertise is acquired, the results of this procedure are acceptable safe and effective.

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Section: Introductionmentioning

confidence: 99%

Endoscopic lumbar discectomy: Experience of first 100 cases

Jhala¹,

Mistry²

2010

IJOO

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“…32,49 1977 United 1958. 1,32,[44][45][46] Over the following decades, advances in both anterior and posterior fixation systems came at a fast pace, with the Dwyer, Zielke, Luque, and CD systems being among the most prominent. 32,45,[47][48][49][50] With these new systems, successful and secure biomechanical fixation became increasingly feasible.…”

Section: Introductionmentioning

confidence: 99%

The historical evolution of the management of spinal cord injury

Schiller¹,

Mobbs²

2012

Journal of Clinical Neuroscience

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“…Закономерным продолжением рентгенографии и значительным прогрессом вертебрологии стала предложенная в 30-х гг. прошлого столетия методика миелографии [28]. Тем не менее межпозвонковый диск не был центром внимания, так как о его связи с ишиасом не было известно.…”

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“…Наиболее успешным оказалась техника гемиламинэктомии, разработанная в Италии [19] [44] ламинарный-экстрадуральный доступ для выполнения дискэктомии [28].…”

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