Our Summary

This research paper compares two types of surgery for people with a specific type of back problem (lumbar disc herniation): microendoscopic discectomy and open discectomy. The researchers looked at prior studies and analyzed data on pain levels, disability, complications, surgery time, blood loss, and length of hospital stay.

They found out that both surgeries are similarly effective in reducing pain and disability, and have similar rates of complications. However, the microendoscopic surgery (which is a less invasive procedure) led to less blood loss and shorter hospital stays. The downside is that it takes longer to perform. The researchers conclude that, despite being more complex to learn, microendoscopic surgery could be a good alternative to the more traditional open surgery for patients with this type of back problem.

FAQs

  1. What are the two types of surgeries compared in this research paper for treating lumbar disc herniation?
  2. Is there a significant difference in pain reduction and disability between microendoscopic discectomy and open discectomy?
  3. What are the advantages and disadvantages of microendoscopic surgery compared to open discectomy?

Doctor’s Tip

A doctor might tell a patient considering a discectomy that while both microendoscopic and open surgery are effective in reducing pain and disability, microendoscopic surgery may result in less blood loss and a shorter hospital stay. It is important to weigh the potential benefits and drawbacks of each procedure and discuss them with your doctor to determine the best option for you.

Suitable For

Patients who are typically recommended for discectomy are those who have been experiencing severe back pain and/or leg pain due to a lumbar disc herniation that has not improved with conservative treatments such as physical therapy, medication, and injections. These patients may also have symptoms such as numbness, weakness, or tingling in the legs or feet. Additionally, patients who have a large disc herniation that is causing compression of the spinal nerves or spinal cord may also be recommended for discectomy.

Timeline

Before the discectomy procedure, a patient typically experiences symptoms such as back pain, leg pain, numbness, and weakness due to a herniated disc pressing on a nerve in the spine. They may undergo various diagnostic tests such as MRI or CT scans to confirm the diagnosis. The patient may also try conservative treatments such as physical therapy, medications, and injections to manage their symptoms.

After the discectomy procedure, the patient is usually monitored in the hospital for a short period of time before being discharged. They will be instructed on post-operative care instructions, including limitations on physical activity and proper wound care. The patient may experience some pain and discomfort after the surgery, which can be managed with pain medications prescribed by their healthcare provider. Physical therapy may also be recommended to help strengthen the muscles in the back and improve mobility. Over time, the patient should experience relief from their symptoms and improved function in the affected area.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a discectomy procedure?
  2. How long is the recovery time after a discectomy surgery?
  3. Will I need physical therapy or rehabilitation after the surgery?
  4. Are there any restrictions or limitations on activity following the surgery?
  5. How likely is it that the herniated disc will reoccur after the surgery?
  6. What are the success rates of microendoscopic discectomy compared to open discectomy in treating lumbar disc herniation?
  7. How experienced are you in performing microendoscopic discectomy procedures?
  8. How long does the surgery typically take to perform?
  9. Will I need to stay in the hospital overnight after the surgery?
  10. Are there any alternative treatments or therapies that I should consider before opting for surgery?

Reference

Authors: He J, Xiao S, Wu Z, Yuan Z. Journal: Eur Spine J. 2016 May;25(5):1373-1381. doi: 10.1007/s00586-016-4523-3. Epub 2016 Mar 21. PMID: 27001138