Our Summary

The study compares two surgical techniques for treating lumbar disk herniation (LDH), a condition that can cause severe back and leg pain. The traditional method is open microdiscectomy (OM), but there is an alternative, considered less invasive, called percutaneous transforaminal endoscopic discectomy (PTED).

The researchers searched multiple online databases to find and analyze relevant studies and trials that compared the two techniques. They focused on the outcomes of leg pain and functional status (how well patients could move and function after the surgery) in the short term (1 day after surgery), intermediate term (3-6 months after surgery), and long term (12 months after surgery).

After reviewing over 2000 studies, they included 14 in their analysis. The results showed varied effects on leg pain in the short term. However, in the intermediate and long term, there didn’t seem to be a significant difference between the two techniques in terms of leg pain or functional status.

In simple terms, the study found that both surgical methods seem to be similarly effective for treating LDH in the long run. However, the researchers note that there’s a need for more high-quality studies on these techniques’ long-term clinical outcomes and cost-effectiveness.

FAQs

  1. What are the two surgical techniques compared in the study for treating lumbar disk herniation?
  2. What outcomes did the researchers focus on in comparing the two surgical techniques?
  3. Did the study find any significant difference in the effectiveness of the two surgical techniques for treating LDH?

Doctor’s Tip

One helpful tip a doctor might give a patient about microdiscectomy is to carefully follow post-operative instructions, including proper lifting techniques, physical therapy exercises, and avoiding activities that could strain the back. It’s also important to attend follow-up appointments and communicate any concerns or changes in symptoms to your healthcare provider.

Suitable For

Patients who are typically recommended for microdiscectomy are those who have lumbar disk herniation (LDH) causing severe back and leg pain that has not responded to conservative treatments such as physical therapy or medications. These patients may have symptoms such as leg pain, numbness, weakness, or difficulty walking due to nerve compression from the herniated disk. Patients with LDH who have not seen improvement with non-surgical treatments and have significant functional limitations may be good candidates for microdiscectomy.

Timeline

Before microdiscectomy:

  1. Patient experiences severe back and leg pain due to lumbar disk herniation.
  2. Patient undergoes diagnostic tests and consultations with a healthcare provider to determine the best course of treatment.
  3. Patient may try conservative treatments such as physical therapy or medication before considering surgery.
  4. Patient decides to undergo microdiscectomy surgery after discussing the risks and benefits with their healthcare provider.

After microdiscectomy:

  1. Patient undergoes microdiscectomy surgery to remove the herniated portion of the disk.
  2. Patient may experience some pain and discomfort immediately after the surgery.
  3. Over the following weeks and months, patient gradually experiences relief from back and leg pain as they recover from the surgery.
  4. Patient undergoes physical therapy and rehabilitation to regain strength and mobility in the affected area.
  5. In the long term, patient experiences improved functional status and reduced pain, allowing them to return to their daily activities and improve their quality of life.

What to Ask Your Doctor

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

  1. What are the potential risks and complications associated with microdiscectomy?
  2. How long is the recovery period after microdiscectomy?
  3. What is the success rate of microdiscectomy for treating my specific condition?
  4. Are there any alternative treatment options to consider before opting for surgery?
  5. Will I need physical therapy or rehabilitation after the surgery?
  6. How soon can I expect to experience relief from my symptoms after the surgery?
  7. Will I need to make any lifestyle changes or modifications post-surgery to prevent future issues?
  8. Are there any restrictions or limitations on physical activity following microdiscectomy?
  9. How frequently will I need to follow up with you after the surgery for monitoring and check-ups?
  10. What can I expect in terms of long-term outcomes and potential recurrence of symptoms after microdiscectomy?

Reference

Authors: Gadjradj PS, Harhangi BS, Amelink J, van Susante J, Kamper S, van Tulder M, Peul WC, Vleggeert-Lankamp C, Rubinstein SM. Journal: Spine (Phila Pa 1976). 2021 Apr 15;46(8):538-549. doi: 10.1097/BRS.0000000000003843. PMID: 33290374