12. EVALUATION ON RESULTS OF MICRODISCECTOMY FOR SEQUESTERED LUMBAR DISC HERNIATION
Main Article Content
Abstract
Objective: The study aims to describe the clinical and paraclinical characteristics and evaluate the results of microdiscectomy in patients with lumbosacral disc herniation with fragmented fragments.
Research subjects and methods: Retrospective description and analysis of a series of cases. Cases undergoing microsurgery to remove lumbar disc herniation with fragmented fragments at the Department of Neurosurgery, Nguyen Tri Phuong Hospital from October 2019 to June 2022. Patients were evaluated for clinical symptoms and imaging before surgery; assess the level of symptom improvement after surgery according to the VAS and Macnab scales.
Results: There were 37 cases, including 21 men and 16 women, the youngest 26 years old, the oldest 76 years old, who underwent microsurgery to remove the herniated nucleus pulposus with loose fragments. The level of nerve root pain according to the VAS scale at the time before surgery and immediately after surgery 24 hours was 8.11 ± 0.90 points and 2.30 ± 1.35 points, respectively. At 3 months after surgery, very good results accounted for 62.2% and good results accounted for 37.8%. Recorded 1 case of dural tear that was treated during surgery. No other complications were noted at 3 months after surgery.
Conclusion: Microsurgery to remove the nucleus pulposus on patients with lumbar disc herniation with separate fragments achieved good results with few complications.
Article Details
Keywords
Herniated disc with fragment, microsurgery to remove disc nucleus
References
[2] Hà Kim Trung, Thoát vị đĩa đệm cột sống thắt lưng, Phẫu thuật thần kinh, Nhà xuất bản Y học, Hà Nội, 2013, tr. 509-516.
[3] Huỳnh Hồng Châu, Vi phẫu thuật thoát vị đĩa đệm thắt lưng, Luận án tiến sỹ y học, Trường Đại học Y Dược thành phố Hồ Chí Minh, 2012.
[4] Nguyễn Tấn Hùng, Phẫu thuật nội soi qua đường liên bản sống điều trị thoát vị đĩa đệm thắt lưng - cùng, Luận văn bác sỹ chuyên khoa cấp II, Trường Đại học Y Dược thành phố Hồ Chí Minh, 2015.
[5] Lê Tường Viễn, Đánh giá kết quả bước đầu điều trị thoát vị đĩa đệm cột sống thắt lưng bằng kỹ thuật nội soi, Luận văn thạc sỹ y học, Trường Đại học Y Dược thành phố Hồ Chí Minh, 2012.
[6] Fisher C et al, Outcome evaluation of the operative management of lumbar disc herniation causing sciatica, Jourrnal Neurosurg, (Spine 4), Vol. 100, 2004, pp. 317-324.
[7] Ajit K et al, Radiology of the spine, Youmans Neurological Surgery, 6th Edition, Elsiever, Philadelphia, USA, 2011, pp. 311-354.
[8] Ruetten S et al, Full - endoscopic interlaminar and transforaminal lumbar discectomy versus conventional microsurgical technique: a prospective, randomized, controlled study, Spine, 2008, 33, pp. 931-939.
[9] Greenberg MS, Spine and spinal cord, Handbook of Neurosurgery, 7th Edition, Thieme, New York, USA, 2010, pp. 428-474.
[10] Choi G et al, Percutaneous endoscopic lumbar discectomy: interlaminar approach, Endoscopic Spinal Surgery, J.P. Medical Ltd., 2013, pp. 107-116.
[11] Võ Xuân Sơn, Ứng dụng nội soi cột sống trong điều trị phẫu thuật cột sống ngực và thắt lưng, Tạp chí Y học thực hành, 2013, số 891 + 892, tr. 21-23.
[12] Ahn Y et al, Transforaminal percutaneous endoscopic lumbar discectomy for upper lumbar disc herniation: clinical outcome, prognostic factors, and technical consideration, Acta Neurochir, Vol. 151, 2009, pp. 199-206.
[13] Silverplats K et al, Clinical factors of importance for outcome after lumbar discherniation surgery: long-term follow-up, Eur. Spine J., Vol. 19, 2010, pp. 1459-1467.
[14] Rihn JA et al, Duration of Symptoms Resulting from Lumbar Disc Herniation: Effect on Treatment Outcomes, J. Bone Joint Surg. Am., Vol. 93, 2011, 1906-1914.
[15] Nygaard OP et al, Duration of symptoms as a predictor of outcome after lumbar disc surgery, Acta Neurochir (Wien), Vol. 128, 1994, pp. 53-56.