Our Summary

This research paper is about a study that was conducted to understand the effectiveness of a surgical technique called Tubular Microdiscectomy (TMD) in treating a condition called recurrent lumbar disc herniation (rLDH). This condition is basically a problem with one of the rubbery discs between the individual bones (vertebrae) that stack up to make your spine.

The researchers looked at patients who had been diagnosed with rLDH through an imaging technique (MRI) and had undergone the TMD procedure between 2012 and 2019. They collected various types of data about these patients, including their gender, age, body mass index, the specifics of their rLDH condition, the interval between their surgeries, and whether they experienced certain complications.

They measured the success of the procedure by looking at the level of leg pain the patients experienced before and after surgery, and how satisfied the patients were with the results. They found that the level of leg pain significantly decreased after the procedure and that the majority of patients were happy with the results.

Although there were some complications experienced by a small number of patients, none of them needed a third surgery. The researchers concluded that TMD appears to be an effective way to treat leg pain caused by rLDH, and it seems to be as effective as another technique called endoscopic technique, but is easier to learn and apply.

FAQs

  1. What is the efficacy of tubular microdiscectomy (TMD) in treating recurrent lumbar disc herniation (rLDH)?
  2. How does TMD compare to the endoscopic technique for treating rLDH?
  3. What are the potential complications of tubular microdiscectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about microdiscectomy is to follow post-operative instructions carefully, including avoiding heavy lifting and bending at the waist to prevent re-injury to the area. It is also important to attend all follow-up appointments and physical therapy sessions to ensure proper healing and recovery.

Suitable For

Patients who are typically recommended for microdiscectomy include those with recurrent lumbar disc herniation confirmed by magnetic resonance imaging, who have not responded to conservative treatments. These patients may present with persistent leg pain and neurological symptoms, such as sciatica or numbness, due to nerve compression caused by the herniated disc. Microdiscectomy is often recommended for patients who have failed to find relief from their symptoms through non-surgical methods, such as physical therapy, medication, or epidural injections. Additionally, patients who have experienced a previous successful lumbar discectomy but have developed a recurrent herniation may also be candidates for microdiscectomy. Overall, the goal of microdiscectomy is to alleviate pain, improve function, and prevent further neurological deficits in patients with lumbar disc herniation.

Timeline

Before microdiscectomy:

  1. Patient experiences severe leg pain due to recurrent lumbar disc herniation (rLDH).
  2. Patient undergoes magnetic resonance imaging to confirm the diagnosis.
  3. Patient may have tried conservative treatments such as physical therapy or medication before opting for surgery.
  4. Patient discusses treatment options with their healthcare provider and decides to undergo tubular microdiscectomy.

After microdiscectomy:

  1. Patient undergoes tubular microdiscectomy surgery.
  2. Postoperatively, patient experiences a significant reduction in leg pain, from 7.46 to 0.80 on the visual analog scale.
  3. Patient reports good or excellent satisfaction with the surgical outcome, according to the modified MacNab criteria.
  4. Complications such as dural tears or re-recurrence may occur in a small percentage of cases, but overall, the surgery is deemed successful in relieving leg pain caused by rLDH.
  5. Patient may undergo follow-up appointments with their surgeon to monitor their recovery and address any concerns.

What to Ask Your Doctor

  1. What is the success rate of tubular microdiscectomy for treating recurrent lumbar disc herniation?
  2. What are the potential complications or risks associated with tubular microdiscectomy?
  3. How long is the recovery time following tubular microdiscectomy?
  4. Are there any alternative treatment options for recurrent lumbar disc herniation?
  5. What can I expect in terms of pain relief and functional improvement after the surgery?
  6. How many surgeries of this type have you performed, and what is your success rate?
  7. Will I need physical therapy or rehabilitation after the surgery?
  8. How long will I need to be off work or limit my activities following the surgery?
  9. What type of follow-up care will be required after the surgery?
  10. Are there any specific precautions or restrictions I need to be aware of during the recovery period?

Reference

Authors: de Nijs L, Fomekong E, Raftopoulos C. Journal: World Neurosurg. 2023 May;173:e401-e407. doi: 10.1016/j.wneu.2023.02.063. Epub 2023 Feb 18. PMID: 36803687