Our Summary

This research paper is about a complication that can occur after surgery to relieve lower back pain caused by a condition called lumbar spinal stenosis. This complication, called disc herniation, is more likely to happen in older patients with deteriorating spinal discs, particularly after a type of surgery known as open lumbar decompression.

The researchers looked back at the records of 563 patients who had one of two types of surgery - either a mini-open bilateral partial laminectomy (a traditional open surgery) or a minimally invasive laminotomy (a less invasive procedure using a tube-like tool).

They found that patients who had the minimally invasive surgery were less likely to experience disc herniation afterwards - only about 1 out of 100 patients had this complication, compared to about 6 out of 100 patients who had the traditional open surgery. This difference was even more noticeable in patients who had surgery at multiple levels of their spine.

The study suggests that the traditional open surgery, because it is more extensive, could make the spine less stable and increase the risk of disc herniation after surgery. Therefore, the less invasive procedure may be a safer option for patients with lumbar spinal stenosis.

FAQs

  1. What is disc herniation and who is more likely to experience it after lumbar decompression surgery?
  2. What was the difference in disc herniation rates between patients who had minimally invasive surgery compared to traditional open surgery?
  3. Why might the traditional open surgery increase the risk of disc herniation after surgery?

Doctor’s Tip

A doctor might recommend to a patient considering spinal decompression surgery to inquire about minimally invasive procedures, as they may have a lower risk of complications such as disc herniation compared to traditional open surgeries. It is important to discuss the potential risks and benefits with your surgeon to determine the best treatment option for your specific condition. Additionally, following post-operative instructions and participating in physical therapy as recommended can help support the healing process and reduce the risk of complications.

Suitable For

Patients who are typically recommended spinal decompression are those who are experiencing symptoms of lumbar spinal stenosis, such as lower back pain, leg pain, numbness, and weakness. These patients may have tried conservative treatments such as physical therapy, medications, and injections, but have not experienced relief.

Additionally, patients who are older and have deteriorating spinal discs may be more at risk for complications such as disc herniation after surgery. Therefore, they may benefit from a minimally invasive approach to spinal decompression to reduce the risk of this complication.

Overall, patients who are considering spinal decompression surgery should discuss their options with their healthcare provider to determine the most appropriate treatment plan based on their individual needs and risk factors.

Timeline

Before spinal decompression surgery, a patient may experience chronic lower back pain, leg pain, numbness or weakness in the legs, difficulty walking or standing for long periods of time, and limited range of motion in the spine. They may have tried conservative treatments such as physical therapy, medication, or injections with little to no improvement in their symptoms.

After spinal decompression surgery, patients may experience relief from their previous symptoms, improved range of motion in the spine, reduced pain and numbness in the legs, and better overall quality of life. They may need to undergo physical therapy to strengthen their back muscles and improve their posture to prevent future issues. It is important for patients to follow their doctor’s post-operative instructions and attend follow-up appointments to monitor their recovery progress.

What to Ask Your Doctor

Some questions a patient should ask their doctor about spinal decompression include:

  1. What type of spinal decompression surgery do you recommend for my condition?
  2. What are the potential risks and complications associated with spinal decompression surgery, including disc herniation?
  3. How does age and the condition of my spinal discs impact the likelihood of experiencing disc herniation after surgery?
  4. Are there alternative treatments or procedures that could be considered instead of spinal decompression surgery?
  5. How experienced are you in performing minimally invasive laminotomy procedures compared to traditional open surgeries?
  6. What is the recovery process like for each type of surgery, and how long can I expect to be out of work or limited in my daily activities?
  7. What can I do to decrease my risk of developing disc herniation after spinal decompression surgery?
  8. How often do patients experience complications like disc herniation after spinal decompression surgery in your practice?
  9. Can you provide me with any resources or information to help me better understand my condition and the recommended surgery?
  10. Are there any specific guidelines or precautions I should follow before and after surgery to optimize my recovery and reduce the risk of complications?

Reference

Authors: Uri O, Alfandari L, Folman Y, Keren A, Smith W, Paz I, Behrbalk E. Journal: J Orthop Surg Res. 2023 Dec 18;18(1):974. doi: 10.1186/s13018-023-04457-2. PMID: 38111077