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Risk factor for unsatisfactory outcome after lumbar foraminal and far lateral microdecompression
Sang-Bum Chang1, Sang-Ho Lee, Yong Ahn
1Department of Orthopedic Surgery, Wooridul Spine Hospital, Chungdam-Dong Kangnam-Gu, Seoul, Korea.
Spine
|May 2, 2006
Summary
Microdecompression effectively treats far lateral disc herniation. However, double herniation significantly increases the risk of poor outcomes, suggesting total facetectomy may be better in these cases.
Area of Science:
- Neurosurgery
- Spinal Surgery
Background:
- Postoperative radicular pain is a known complication of far lateral and foraminal microdecompression.
- Detailed analysis of risk factors for unsatisfactory outcomes remains limited.
Purpose of the Study:
- To evaluate risk factors associated with unsatisfactory outcomes after microdecompression for far lateral disc or foraminal stenosis.
- To identify predictors of persistent or recurrent leg pain and need for revision surgery.
Main Methods:
- Retrospective study of 184 patients undergoing microdecompression via a lateral intermuscular approach.
- Follow-up exceeded 2 years, assessing outcomes based on leg pain scores and revision surgery.
- Analyzed potential risk factors including patient demographics, symptom duration, and surgical findings like double herniation.
Main Results:
- 21.7% of patients experienced persistent or recurrent leg pain, with 4.9% requiring revision surgery.
- Double herniation (intracanalicular disc at the same level) was identified as a significant risk factor for unfavorable outcomes (Odds Ratio = 2.89, P = 0.004).
Conclusions:
- Facet-preserving microdecompression is effective for far lateral root compression.
- Total facetectomy may be a preferable surgical approach in cases of double herniation to improve outcomes.