Our Summary

This research paper looks at two different methods of treating lumbar disc herniation, a condition where the cushioning discs between the vertebrae in the lower back bulge out of place. The two methods are lumbar microdiscectomy (LMD) and unilateral biportal endoscopic discectomy (UBE).

LMD is the traditional treatment and is considered the best option. UBE, however, is a newer option that involves using an endoscope, a small camera to perform the surgery. UBE is gaining popularity because it doesn’t require expensive equipment, and it is similar in approach to the traditional LMD.

The study compared the results of both methods by looking at past patients who had one of these surgeries at the same hospital. They compared things like complications, recurrence of the issue, post-surgery pain, patient satisfaction, and quality of life.

The study found that both methods had similar results in all the areas they compared. The only differences were that LMD surgeries were quicker, but UBE surgeries had less blood loss and patients stayed in the hospital for less time after surgery.

In conclusion, while LMD is still considered the best option, UBE is showing to be a strong alternative. UBE could be a good choice for doctors who prefer minimally invasive surgeries.

FAQs

  1. What are the two methods of treating lumbar disc herniation discussed in the research paper?
  2. How does the unilateral biportal endoscopic discectomy (UBE) method differ from the traditional lumbar microdiscectomy (LMD)?
  3. How did the results of LMD and UBE surgeries compare in terms of complications, recurrence, post-surgery pain, patient satisfaction, and quality of life?

Doctor’s Tip

One helpful tip a doctor might tell a patient about microdiscectomy is to follow the post-operative care instructions carefully. This may include avoiding certain activities, taking prescribed medications, attending physical therapy, and attending follow-up appointments. Following these instructions can help ensure a successful recovery and reduce the risk of complications.

Suitable For

Patients who are typically recommended for microdiscectomy are those who have not responded to conservative treatments such as physical therapy, medications, and injections. They may be experiencing symptoms such as severe back pain, leg pain, numbness, or weakness due to a herniated disc pressing on a nerve in the lower back.

Candidates for microdiscectomy surgery are usually those with a single, clearly defined disc herniation that is causing nerve compression and symptoms that have not improved with non-surgical treatments. Patients who have significant neurological deficits such as muscle weakness or loss of bladder or bowel control may also be recommended for surgery.

It is important for patients to discuss their symptoms and treatment options with their healthcare provider to determine if microdiscectomy is the appropriate treatment for their condition.

Timeline

Timeline of patient experiences before and after microdiscectomy:

Before surgery:

  1. Patient experiences lower back pain, leg pain, and/or numbness due to lumbar disc herniation.
  2. Patient undergoes physical examination, imaging tests (such as MRI or CT scan), and consultation with a spine specialist to determine the best treatment option.
  3. Patient and doctor decide on microdiscectomy as the treatment plan.
  4. Patient receives preoperative instructions and prepares for surgery.

During surgery:

  1. Patient is placed under general anesthesia.
  2. Surgeon makes a small incision in the lower back to access the affected disc.
  3. Surgeon removes the portion of the herniated disc that is pressing on the nerve roots.
  4. Surgery typically takes 1-2 hours.

After surgery:

  1. Patient wakes up in the recovery room and may experience some pain and discomfort at the incision site.
  2. Patient is monitored for a few hours before being discharged home.
  3. Patient is advised to rest and avoid heavy lifting or strenuous activities for a few weeks.
  4. Patient may undergo physical therapy to help with recovery and strengthen the back muscles.
  5. Patient gradually resumes normal activities and experiences relief from the symptoms of lumbar disc herniation.
  6. Patient follows up with the surgeon for postoperative evaluation and monitoring of the surgical site.
  7. Patient experiences improvement in quality of life, reduced pain, and increased mobility.

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 surgery?
  2. How long is the recovery time after microdiscectomy surgery?
  3. What are the expected outcomes of microdiscectomy surgery in terms of pain relief and functional improvement?
  4. Are there any alternative treatments to microdiscectomy that I should consider?
  5. How many microdiscectomy surgeries have you performed, and what is your success rate?
  6. Will I need physical therapy or rehabilitation after microdiscectomy surgery?
  7. How long will I need to stay in the hospital after the surgery?
  8. Will I need to take any medications after the surgery, and if so, what are the potential side effects?
  9. How soon can I return to work and normal activities after microdiscectomy surgery?
  10. What can I do to help ensure a successful outcome from microdiscectomy surgery?

Reference

Authors: Özer Mİ, Demirtaş OK. Journal: J Neurosurg Spine. 2023 Dec 8;40(3):351-358. doi: 10.3171/2023.10.SPINE23718. Print 2024 Mar 1. PMID: 38064698