PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Diskectomy”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources
PubMed2002

Lumbar diskectomy with preservation of the ligamentum flavum.

RE: Aydin Y, Ziyal IM, Duman H, Türkmen CS, Başak M, Sahin Y. Clinical and radiological results of lumbar microdiskectomy technique with preserving of ligamentum flavum comparing to the standard microdiskectomy technique. Surg Neurol 2002;57:5-14. The authors compare results of surgery in 400 patients who underwent microdiskectomy with preservation of the ligamentum flavum (Group 1) with those of 200 patients operated on by standard microdiskectomy (Group 2). Mean follow-up was 36.8 months in Group 1 and 32.4 months in Group 2; outcome was evaluated clinically and by patient questionnaire. Early clinical outcome was satisfactory in 96.75% of patients in Group 1 and in 81.5% in Group 2; reoperation rates were 4.5% and 9%, respectively. Overall success rate based on the patient questionnaire was 91% in Group 1 and 76% in Group 2. The authors conclude that the ligamentum flavum preservation technique is helpful in achieving good long-term results.

Diskectomy↗
PubMed2002

[Anterior cervical diskectomy and interbody arthrodesis using Cloward technique: retrospective study of complications and radiological results of 167 cases].

PATIENTS AND METHODS: We performed a retrospective analysis of complications and radiological results in 167 patients surgically treated, for discal or spondylotic disease of the cervical spine, with Cloward procedure. Using uni and multivariate analysis, we tried to identify risk factors that might be correlated with surgical complications or radiological results. RESULTS: Surgical treatment was indicated for cervical radiculopathy in 68% of the patients and for myelopathy or radiculomyelopathy in the remaining 32%. The pathologic disease responsible of the symptomatology was soft disk herniation in 59% of the cases and spondylotic changes in 41%. The patients that underwent surgery because of myelopathy were one decade older, had a longer symptomatic period and presented multi-segmentary spondylotic disease with higher frequency than patients affected of radiculopathy. The most common segments operated were CS-C6 (44.3%) and C6-C7 (30.5%). Surgical mortality was 0.6% and morbidity 29.3%. Most of the complications were transient, although 4.8% of the patients developed permanent neurological deterioration. CONCLUSIONS: Complications were most commonly seen in the group of the patients undergoing surgery because of long-lasting myelopathy with multi-segmentary spondylotic disease, in those with vascular risk factors and in those operated of more than one segment. Surgeon anatomic knowledge and experience are critical for diminishing such complications. Non-union rate was 9.6%, and another 9.6% of the patients developed post-surgical kyphosis. Both factors correlated with the need of re-operation.

Adult↗
PubMed2000

[Intraoperative management of unexpected arterial hypotension during lumbar diskectomy].

An anesthesiological management is difficult in surgical procedures in which the operative situs is not to be seen by the anesthesist. Therefore specific knowledge of the operative procedure and related hazards are mandatory for optimal anesthesiological care. By describing the anesthesiologic proceduces in two lumbar discectomys, the specific problems in recognition and treatment of severe injuries of retroperitoneal vascular structures are explained. In addition, the differential diagnosis of intraoperative arterial hypotension is described. The communication between all disciplines involved is mandatory, especially in cases of severe complications. The management of such complications can only be solved through in-time interdisciplinary cooperation of all involved disciplines.

Aged↗
PubMed1998

[The assessment of the morphological changes after ventral diskectomy by thin-section computed tomography].

PURPOSE: We examined the changes of the intervertebral body space, the morphology of bone cement interponates and vertebrae after cervical discectomy and ventral fusion with high resolution CT. MATERIALS AND METHODS: CT scans were performed on 25 patients preoperatively, one week and six months after cervical discectomy and ventral fusion. RESULTS: There was no change in the size of the interponates. During follow-up new ossifications were found in 18 of the patients, two of them with neurological deficits. While directly after surgery the sagittal spinal canal diameter was enlarged, six months later particularly the lateral width was found to be reduced. After surgery soft tissue already narrowed the spinal canal in similar shape as the former prolapse. CONCLUSION: We conclude that postoperative neurologic deficits can only be partially explained by the described structural changes, because similar findings were made in uncomplicated postoperative courses as well as in patients with deficits.

Adult↗
PubMed1994

[The results of percutaneous diskectomy. The course of pain, work capacity and therapy failure].

In a prospective study extending from November 1989 to December 1992 percutaneous discectomy was carried out in 50 patients (26 men, 24 women, mean age 41 [19-73] years). The aim of the study was to ascertain the efficacy of this new mode of treatment, and its indications. The patients selected for the procedure had chronic, therapy-resistant lumboradicular pain syndrome of at least six weeks' duration; imaging procedure had to show a "bulging disc" and neurological deficits had to be no more than minor. During the subsequent follow up period of 22 +/- 9.6 months 35 of the 50 patients did not require any further surgery; 24 of them (69%) resumed full work while seven (20%) regained partial (50%) working capacity. However, the operation proved ineffective in four of these 35 patients (11%). Fourteen of the 50 patients (28%) had persistent pain and required revision by open classical discectomy; seven of them resumed full work and one regained 50% working capacity. The most frequent findings at this revision were stenosis of the subarticular recess in combination with persistent forward bulging of the longitudinal ligament and anulus fibrosus (n = 7), calcification of the posterior longitudinal ligament (n = 1) and an intervertebral disc sequestrum which gave a false negative results on discography (n = 2). In another case there was a genuine recurrence 35 months after a successful percutaneous procedure; this was treated successfully by open operation. When performed at the level L5/S1, the procedure gave unsatisfactory results in five out of six cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2000

[Diskectomy of the lumbar spine: indication and contraindications].

The authors present an overview of the principles of surgical treatment of lumbar disc herniation which are currently applied at spinal surgery ward by the Orthopedic Department of the Poznan School of Medical Sciences. Most of these principles are valid in spinal surgery centres in USA and most European countries. The authors reviewed surgical technique, indications, contrindications and complications related to discectomy in the lumbar spine. Although the articles deals mainly with "classical" discectomy, other surgical techniques (microdiscectomy, percutaneous discectomy, chemonucleolysis, and endoscopy-assisted discectomy) are also briefly reviewed. Careful selection of patients, meticulous analysis of radiographic findings and proper surgical technique yield good results which allow most patients to improve their life conditions and lead a pain-free existence.

Contraindications↗
PubMed2000

Percutaneous diskectomy in the treatment of herniated lumbar disks.

APLD and the minimally invasive approach to spine surgery has stood the test of time successfully. With the advent of new imaging technologies to aid in the guidance of spine procedures, such as three-dimensional ultrasound, interventional MR imaging, and fluoroscopic CT, and the development of flexible instruments that can be navigated within the disk, the stage is now set for major breakthroughs in the treatment of herniated lumbar disks (i.e., the minimally invasive removal of extruded and free disk fragments). With the active role of radiologists and sophisticated imaging, minimally invasive spinal intervention has a bright and exciting future.

Diskectomy↗
PubMedDate not supplied

[Use of laser- and extremely high frequency magnetic therapy in the preoperative period before diskectomy].

Electromagnetic therapy and tractions contributed to reduction of neurovascular structures compression evident not only from regression of clinical symptoms but also from improvement of regional hemodynamics, functional condition of the affected nerves and muscles of the limbs. This prediscectomy preparation appeared an effective conservative treatment for 69% patients. The rest patients benefited from such preoperative preparation which provided stabilization of the patients' condition before and after dyscectomy.

Diskectomy↗
PubMed2003

[Results of lumbar diskectomy].

PURPOSE OF THE STUDY: We evaluated the outcomes of lumbar discectomies in relation to the presence or absence of degenerative spinal lesions and the surgical treatment used in order to determine the extent to which these factors influence the result of treatment. MATERIAL: Patients who were treated by discectomy in the period from January 1, 1994, to July 7, 1998, were contacted. A total of 132 subjects received the Oswestry questionnaire (in two copies) in February 2002 and 100 of them, 62 men and 38 women, were included in the final evaluation. The average age of the patients at the time of surgery was 42.86 years (range, 15 to 69 years). The average follow-up period was 3.22 years. All patients underwent preoperative neurological check-up and examination by X-ray, contrast perimyelography, magnetic resonance imaging or computer tomography. The surgical procedure involved either microdiscectomy according to Caspar or conventional open discectomy. METHODS: The patients were allocated to four groups on the basis of the presence or absence of degenerative lesions shown by pre-operative or intra-operative findings and of the surgical treatment used. Each group was evaluated individually. Group 1 comprised 15 patients without degenerative lesions and group 2 included 19 patients with degenerative lesions; both groups were treated by the Caspar method. Groups 3 and 4 were treated by open discectomy and consisted of 32 patients without and 34 patients with degenerative lesions, respectively. The patients reported their pre- and post-operative complaints retrospectively, using a separate copy of the Oswestry Low Back Pain Disability Quiestionnaire, Version 1.0, for each period. RESULTS: In the whole sample, the average improvement estimated by the Oswestry Disability Index (ODI) was 30.32% in the year 2002, as compared with 54.15% before surgical treatment. The best outcome, improvement by 45.87%, was in group 1. Groups 2, 3 and 4 showed improvements by 31.95%, 30.35% and 22.38%, respectively. DISCUSSION: The Oswestry questionnaire has become a widely-used instrument for evaluation of complaints in patients with spinal disorders. Its universal application enabled us to compare the results of different studies. The presence of degenerative lesions was responsible for less successful outcomes of both the Caspar microdiscectomy and open discectomy. It remains to be answered to what extent these poorer outcomes in spines with degenerative lesions are related to the instability of the segments treated. However, it is apparent that the Caspar microdiscectomy improved the patients' conditions more than open discectomy. CONCLUSIONS: The average 30.32% decrease in ODI score from 54.15% before the surgical tree of intervertebral discs herniation, as evaluated at an average of 3.22 years after surgery, is regarded as a good outcome. The Oswestry questionnaire generally permits a reliable assessment of patient complaints. In this study, a Czech translation of Version 2.0 of this questionnaire is presented and recommended for use. The presence of serious degenerative spinal lesions makes the outcomes of discectomy less satisfactory. Prospects for the approach that combines discectomy with fusion can be assessed in patients whose indications are well defined and complaints exactly evaluated.

Adolescent↗
PubMed2003

[Acute cervical epidural hematoma as a complication of anterior cervical C5-C6 diskectomy. A case report].

A 32 year-old woman with cervico-brachial pain and progressive neurological disorders was admitted to the Department and Clinic of Neurosurgery and Neurotraumatology of the K. Marcinkowski University of Medical Sciences in Poznań. Neurological examination revealed right hemiparesis with muscular atrophy in the right upper limb, progressing in the past 3 months. MRI demonstrated relatively large herniations of C4-C5 and C5-C6 discs with spinal and nerve compressions. A surgery was carried out. Discectomy of C4-C5 and C5-C6 discs was performed using the anterior vertebral approach. After the removal of C4-C5 and C5-C6 discs and C5 vertebral body a fragment of the iliac bone strut was wedged between C4 and C6 vertebral bodies. The bone graft was fixed to C4 and C6 vertebral bodies with a titanium plate. Within 6 hours after the surgery the patient developed a complete loss of motor functions in the upper and lower limbs. MRI scan of the cervical spine showed a huge anterior epidural hematoma compressing the spinal cord. An emergency re-operation and removal of the hematoma was performed by the anterior approach. A complete neurological recovery followed during the first 24 postoperative hours.

Acute Disease↗
PubMed1994

[Lumbar disk hernia. Excision of hernia with or without complementary diskectomy?].

The authors compare the limited removal of the ruptured disc to discectomy for lumbar disc herniation. Analysis of results during a four years period demonstrates a twice higher recurrence rate with limited removal than with discectomy and a more frequent residual low back pain, after limited removal of the ruptured disc. These data made then limit the indications of the simple ruptured disc removal technique, with the exception of some specific anatomical locations: the migrated disc situated anterior or posterior to the ligament, without an associated discal bulging.

Adult↗
PubMed1994

[Changes in the paravertebral musculature following a traditional herniated lumbar diskectomy. A computed tomographic and magnetic resonance study].

On the basis of previous EMG data, a retrospective study was carried out on the CT and MR features of the paravertebral musculature after lumbar spine surgery through the posterior approach. The authors reviewed the CT scans and some MR images of 35 symptomatic patients hospitalized 7 months to 42 years after operation for disc herniation. Changes in the paraspinal musculature were apparent in all of them on the surgical side. The changes were minimal or very slight in 14 patients, moderate in 13 and severe in 8. A close correlation was observed between the above changes and the surgical procedure used in every single case. Histology showed atrophy and degeneration of the muscle fibres and fibrofatty substitution. The possible responsible causes of damage to the postvertebral muscles during spinal surgery are briefly mentioned and practical implications discussed.

Adult↗
PubMed1993

[Discitis after lumbar diskectomy].

The aim of this study was to examine the frequency and clinical course for early diagnosis (earlier signs-index of suspicion, later signs) and different clinical presentation of disctitis at deep infection wound (DIW) and superficially infection wound (SIW). The medical histories of adult patients, which were all hospitalized after lumbar discectomy at the Department of Rehabilitation during a 5-year period (1986-1990) was retrospectively analysed. The incidence of discitis by 231 patients was 0.43%. DIW 0.43%, and SIW 0.86% is incidence by 231 patients. Infection group with seven patients (three discitis, two DIW, two SIW) and control seria of 52 patients (to be clinically satisfactory) was studied in detail, to the clinical presentation. The most consistent clinical signs at previous diagnosis all patients with discitis, beside 1) delayed strong back pain and 2) erythrocite sedimentation rate (ESR) highly elevated (near 50) in week 2, is 3) increasing course of ESR from week 2 to 4, postoperatively. On the contrary, all patients with DIW and SIW had an decreasing course of ESR from week 2 to 4, postoperatively. ESR of all patients with DIW > 50 < SIW on week 2 postoperatively, which is important for their differentiation along with local signs of the wound. The later signs for diagnosis and differentiation of all patients with discitis from DIW and SIW are typical radiographic findings on discitis, and duration of ESR normalization, beside other signs here analyzed.

Adult↗