Vertebral End-Plate Perforation for Intervertebral Disc Height Preservation After Single-level Lumbar Discectomy

Vodičar, Miha; Košak, Robert; Gorenšek, Matevž; Korez, Robert; Vrtovec, Tomaž; Koder, Jadran; Antolič, Vane; Vengust, Rok

doi:10.1097/bsd.0000000000000305

Cited by 5 publications

(9 citation statements)

References 26 publications

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“…Parker et al also reported that 32% of patients suffered back pain after conventional discectomy, and 9% of cases underwent fusion surgery for pain control [ 20 ]. Vodicar et al reported that invasive procedures, including endplate perforation, decrease vertebral height and worsen back pain in the postoperative period [ 21 ]. Scarring of the epidural space can be problematic [ 22 – 24 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical comparison of unilateral biportal endoscopic technique versus open microdiscectomy for single-level lumbar discectomy: a multicenter, retrospective analysis

Kim

Kang²,

Hong³

et al. 2018

J Orthop Surg Res

129

106

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BackgroundThe unilateral biportal endoscopic (UBE) technique is a minimally invasive procedure for spinal surgery, while open microscopic discectomy is the most common surgical treatment for ruptured or herniated discs of the lumbar spine. A new endoscopic technique that uses a UBE approach has been applied to conventional arthroscopic systems for the treatment of spinal disease. In this study, we aimed to compare and evaluate the perioperative parameters and clinical outcomes, including recovery from surgery, pain and life quality modification, patient’s satisfaction, and complications, between UBE and open lumbar microdiscectomy (OLM) for single-level discectomy procedures.MethodsThis study included 141 patients with degenerative disc disease requiring discectomy at a single level from L2–L3 to L5–S1. A total of 60 and 81 patients underwent UBE and OLM, respectively. Analysis was based on comparison of perioperative metrics, operation time (OT); estimated blood loss (EBL); length of hospital stay (HS); clinical outcomes, including assessment using the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI); patient satisfaction (the MacNab score); and the incidence of reoperation and complications.ResultsThe study cohort was 56.7% women, and the mean patient age was 50.98 ± 18.23 years. The mean VAS (the back and leg), MacNab score, and ODI improved significantly from the preoperative period to the last follow-up (12.92 ± 3.92) in both groups (p < 0.001). One week after operation, the back VAS score in the UBE group showed significantly more improvement than that in the OLM group. However, the 1-week, 3-month, and 12-month VAS (the back and leg), ODI improvement, modified MacNab score, and OT were not significantly different between the two groups. In the UBE group, EBL (34.67 ± 16.92) was smaller and HS (2.77 ± 1.2) was shorter than that of the OLM group (140.05 ± 57.8, 6.37 ± 1.39). However, OT (70.15 ± 22.0) was longer in the UBE group than in the OLM group (60.38 ± 15.5), and the difference was statistically significant. Meanwhile, the differences in the rate of surgical conversion and complications between the two groups were not statistically significant.ConclusionsThe UBE for single-level discectomy yielded similar clinical outcomes to OLM, including pain control, functional disability, and patient satisfaction, but incurred minimal EBL, HS, and postoperative back pain.Trial registrationNot applicable.Electronic supplementary materialThe online version of this article (10.1186/s13018-018-0725-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Clinical comparison of unilateral biportal endoscopic technique versus open microdiscectomy for single-level lumbar discectomy: a multicenter, retrospective analysis

Kim

Kang²,

Hong³

et al. 2018

J Orthop Surg Res

129

106

View full text Add to dashboard Cite

show abstract

“…Parker et al also reported that 32% of patients suffered back pain after conventional discectomy, and 9% of cases underwent fusion surgery for pain control [12]. Vodicar et al reported that invasive procedures, including endplate perforation, decrease vertebral height and worsen back pain in the postoperative period [13].…”

Section: Discussionmentioning

confidence: 99%

Clinical effect of unilateral biportal endoscopy in the treatment of lumbar diseases: a systematic review and meta-analysis.

Xie¹,

Zhang²,

Liu³

2021

Videosurgery and Other Miniinvasive Techniques

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“…1). Eighteen studies met the selection criteria for the purposes of the present review, which included two RCTs [27,28] and 16 observational studies [12,[29][30][31][32][33][34][35][36][37][38][39][40][41][42][43].…”

Section: Study Selectionmentioning

confidence: 99%

“…DH method-1b on L1/2-L5S1: average of anterior, middle, and posterior DH = (a + b + c)/3) to measure the DH [28,29,31,32,36,[41][42][43].…”

Section: Study Characteristicsmentioning

confidence: 99%

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The association between pain scores and disc height change following discectomy surgery in lumbar disc herniation patients: a systematic review and meta-analysis

et al. 2021

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Purpose To evaluate the impact of discectomy on disc height (DH) in lumbar disc herniation (LDH) patients following discectomy surgery and address the association of DH change with pain score change. Methods We searched three online databases for randomized controlled trials (RCTs) and observational studies. In LDH patients, eligible for discectomy surgery, the changes in pre-and post-operative back and/or leg pain score and DH and/or disc height index (DHI) were considered as primary outcomes. Standardize mean difference (SMD) and their 95% confidence intervals (CI) were evaluated. The GRADE approach was used to summarize the strength of evidence. Results Two RCTs and sixteen observational studies were included in the analysis of 893 LDH patients undergoing discectomy surgery. The mean overall follow-up was 211 weeks. There was a statistically significant reduction in DH (14.4% reduction: SMD = −0.74 (95% CI = −0.86 to −0.61)) and DHI (11.5% reduction: SMD = −0.81 (95% CI = −0.97 to −0.65)) following discectomy surgery. There was a significant relationship between the reduction in DH and decrease in back pain score (r = 0.68, (95% CI = 0.07-1.30), p = 0.034) after discectomy surgery. No significant relationship between DHI change and decrease in clinical pain scores (back and leg pain) could be established. Conclusion Discectomy surgery produces significant and quantifiable reductions in DH and DHI. Additionally, the reduction in DH is responsible for the decrease in back pain scores post discectomy, but further studies will improve understanding and aid preoperative counselling.

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Vertebral End-Plate Perforation for Intervertebral Disc Height Preservation After Single-level Lumbar Discectomy

Cited by 5 publications

References 26 publications

Clinical comparison of unilateral biportal endoscopic technique versus open microdiscectomy for single-level lumbar discectomy: a multicenter, retrospective analysis

Clinical comparison of unilateral biportal endoscopic technique versus open microdiscectomy for single-level lumbar discectomy: a multicenter, retrospective analysis

Clinical effect of unilateral biportal endoscopy in the treatment of lumbar diseases: a systematic review and meta-analysis.

The association between pain scores and disc height change following discectomy surgery in lumbar disc herniation patients: a systematic review and meta-analysis

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