Our Summary

This study investigated if there’s a difference in the success of two kinds of back surgery (microscopic and biportal endoscopic discectomy) in obese patients suffering from lumbar disc herniation - a condition where the cushion between the bones in the spine pushes out of its normal position.

In simpler terms, they wanted to find out if one surgery was better than the other for obese patients with a specific type of back problem.

They looked at 73 patients, 43 of whom had the microscopic surgery and 30 who had the biportal endoscopic surgery. They used a few different scales to measure pain and disability before and after the surgery and also used MRI scans to see if the disc herniation recurred after surgery.

In the end, they found that patients in both groups saw improvements in pain and disability after surgery, and there was no significant difference between the two types of surgeries in terms of patient outcomes. However, there were fewer minor complications in the group who had the biportal endoscopic surgery.

So overall, for obese patients with this type of back problem, both surgeries seem to be effective, but the biportal endoscopic surgery might have a slight advantage because it led to fewer minor complications.

FAQs

  1. What types of back surgery were investigated in the study?
  2. Was there a significant difference in success rates between the microscopic and biportal endoscopic discectomy surgeries?
  3. Did the study find any advantages to using biportal endoscopic surgery for obese patients with lumbar disc herniation?

Doctor’s Tip

One helpful tip a doctor might tell a patient about discectomy is to maintain a healthy weight through proper diet and exercise. Obesity can put added stress on the spine, leading to a higher risk of disc herniation and other spinal issues. By maintaining a healthy weight, patients can help reduce the likelihood of needing surgery in the future and improve their overall spinal health. Additionally, following post-operative rehabilitation exercises and instructions provided by the healthcare team can help optimize recovery and prevent future complications.

Suitable For

Patients who are typically recommended for discectomy are those who have not found relief from conservative treatments such as physical therapy, medications, and injections for their back pain caused by a herniated disc. Obese patients with lumbar disc herniation may be recommended for discectomy if their symptoms are severe and impacting their quality of life. It is important for patients to discuss their individual case with a healthcare provider to determine if discectomy is the right treatment option for them.

Timeline

  1. Patient experiences back pain and possibly sciatica symptoms due to lumbar disc herniation.
  2. Patient undergoes evaluation by a healthcare provider, which may include physical examination, imaging tests such as MRI, and discussion of treatment options.
  3. Patient and healthcare provider decide on surgical intervention, in this case either microscopic or biportal endoscopic discectomy.
  4. Patient undergoes pre-operative preparations, which may include blood tests, medication adjustments, and instructions for the day of surgery.
  5. Patient undergoes the discectomy surgery, which involves removing the herniated portion of the disc to relieve pressure on the nerves.
  6. Patient recovers in the hospital for a few days, with pain management and physical therapy as needed.
  7. Patient is discharged from the hospital and continues to recover at home, following post-operative instructions provided by the healthcare team.
  8. Patient attends follow-up appointments to monitor healing, pain levels, and function.
  9. Patient experiences gradual improvement in pain and function over the following weeks to months.
  10. Patient may continue with physical therapy and other treatments to support recovery and prevent future issues.
  11. Patient undergoes follow-up imaging tests to evaluate the success of the surgery and check for any recurrence of disc herniation.
  12. Patient continues to monitor and manage their back health with the guidance of their healthcare provider.

What to Ask Your Doctor

Some questions a patient should ask their doctor about discectomy include:

  1. What are the potential risks and complications associated with the surgery?
  2. How long is the recovery period after the surgery?
  3. Will I need physical therapy or rehabilitation after the surgery?
  4. What is the success rate of this surgery for patients with my specific condition?
  5. Are there any alternative treatments or procedures that I should consider before opting for surgery?
  6. How long do the effects of the surgery typically last?
  7. Will I need to make any lifestyle changes or modifications after the surgery to prevent future issues?
  8. What type of anesthesia will be used during the surgery?
  9. How many of these surgeries have you performed, and what is your success rate?
  10. Are there any specific pre-operative or post-operative instructions I should follow to ensure the best possible outcome?

Reference

Authors: Choi JY, Park HJ, Park SM, You KH, Kang MS, Hwang JY, Yoon JH, Kim HJ, Yeom JS. Journal: Acta Neurochir (Wien). 2023 Sep;165(9):2641-2650. doi: 10.1007/s00701-023-05686-4. Epub 2023 Jul 1. PMID: 37393400