Our Summary

This research paper is about a study that compared two types of surgeries used to treat a condition called lumbar disc herniation, which is when a disc in the lower back herniates, or slips out of place. The two types of surgeries are microendoscopic discectomy and conventional open discectomy.

The researchers looked at multiple studies from China to compare the effectiveness and safety of these surgeries. They used a software to analyze the data from these studies, looking at factors like how successful the surgeries were, how long they took, how much blood was lost, how long patients had to stay in bed and in the hospital, and what complications arose.

They found 20 studies with a total of about 5,000 cases. The results showed that patients who had the microendoscopic discectomy surgery had better success rates, lost less blood, spent less time in bed and in the hospital, and were able to go back to their daily activities faster than those who had the conventional open discectomy surgery. However, the time it took to perform the surgeries and the rate of complications were similar for both types of surgeries.

The conclusion is that both types of surgeries are safe and effective for treating lumbar disc herniation. However, the microendoscopic discectomy surgery might be a better choice when certain conditions are present because it has fewer downsides.

FAQs

  1. What are the two types of surgeries compared in the study for treating lumbar disc herniation?
  2. What were the results of the study comparing microendoscopic discectomy and conventional open discectomy surgeries?
  3. Is one type of surgery considered better than the other for treating lumbar disc herniation according to the study?

Doctor’s Tip

A doctor may advise a patient considering a discectomy to discuss the option of microendoscopic discectomy with their surgeon, as it may result in better outcomes with less blood loss, shorter recovery times, and lower risk of complications compared to conventional open discectomy. It is important for the patient to understand the benefits and potential risks of each type of surgery in order to make an informed decision about their treatment.

Suitable For

Patients who are typically recommended for discectomy surgery are those who have not responded to non-surgical treatments such as physical therapy, medication, and injections. They may be experiencing symptoms such as severe back pain, leg pain, numbness, weakness, and difficulty walking or standing. Patients with a confirmed diagnosis of lumbar disc herniation through imaging tests such as MRI or CT scans are also candidates for discectomy surgery.

Additionally, patients who have tried conservative treatments for at least 6-12 weeks without improvement, have significant nerve compression causing symptoms like sciatica, and have a herniated disc that is causing severe pain or neurological deficits are recommended for discectomy surgery. It is important for patients to discuss their symptoms, medical history, and treatment options with their healthcare provider to determine if discectomy surgery is the right choice for them.

Timeline

Before the discectomy surgery, a patient typically experiences symptoms such as lower back pain, leg pain, numbness, tingling, and weakness. They may undergo imaging tests such as an MRI or CT scan to confirm the diagnosis of lumbar disc herniation. The patient may also try conservative treatments such as physical therapy, medications, and epidural injections to manage their symptoms.

After the discectomy surgery, the patient will likely experience some pain and discomfort at the surgical site. They will be monitored in the hospital for a short period of time before being discharged. The patient will be advised to avoid certain activities and to gradually increase their activity level as they recover. Physical therapy may be recommended to help strengthen the muscles in the back and abdomen to support the spine.

Overall, the goal of the discectomy surgery is to alleviate the symptoms caused by the herniated disc and improve the patient’s quality of life. With proper post-operative care and rehabilitation, most patients are able to return to their normal activities within a few weeks to months after the surgery.

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 both microendoscopic discectomy and conventional open discectomy?

  2. How long will the recovery process be for each type of surgery?

  3. Will I need physical therapy or rehabilitation after the surgery, and if so, for how long?

  4. What are the success rates for each type of surgery in treating lumbar disc herniation?

  5. How much experience do you have performing both microendoscopic discectomy and conventional open discectomy surgeries?

  6. Are there any specific factors or conditions that would make me a better candidate for one type of surgery over the other?

  7. How long will the surgery take, and will I need to stay in the hospital overnight?

  8. What are the expected outcomes in terms of pain relief and improvement in mobility after the surgery?

  9. Are there any alternative treatments or procedures that could be considered for my condition?

  10. How soon after the surgery can I expect to return to work and normal daily activities?

Reference

Authors: Ying XM, Jiang YL, Xu P, Wang P, Zhu B, Guo SQ. Journal: Zhongguo Gu Shang. 2016 Aug 25;29(8):744-751. doi: 10.3969/j.issn.1003-0034.2016.08.014. PMID: 29282935