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Related Concept Videos

Herniated Intervertebral Disc l: Introduction01:29

Herniated Intervertebral Disc l: Introduction

Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...

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Related Experiment Video

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A Suture Technique for Ruptured Annulus Fibrosus Following Decompression Under Percutaneous Transforaminal Endoscopic Discectomy
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Surgical techniques for sciatica due to herniated disc, a systematic review.

Wilco C H Jacobs1, Mark P Arts, Maurits W van Tulder

  • 1Department of Neurosurgery, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300 RC, Leiden, The Netherlands. w.c.h.jacobs@lumc.nl

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|July 21, 2012
PubMed
Summary
This summary is machine-generated.

Surgical techniques for sciatica due to disc herniation, including open, microscopic, and tubular discectomy, show no clinically significant differences in effectiveness. More high-quality research is needed to compare these spine surgery options.

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Area of Science:

  • Neurosurgery
  • Orthopedics
  • Evidence-based medicine

Background:

  • Disc herniation causing sciatica is a common cause of low-back disorders and spine surgery.
  • Previous Cochrane reviews on surgical techniques for sciatica were last updated in 2007.

Purpose of the Study:

  • To update the Cochrane review on the effectiveness of surgical techniques for sciatica resulting from disc herniation.
  • To compare open discectomy, microscopic discectomy, and tubular discectomy.

Main Methods:

  • A comprehensive search of multiple databases and trial registries was conducted in April 2011.
  • Included only randomized controlled trials (RCTs) comparing surgical management of sciatica due to disc herniation.
  • Excluded studies on chemonucleolysis, scar tissue prevention, or comparisons with conservative treatment.

Main Results:

  • Sixteen RCTs were included, with four having a low risk of bias.
  • Microscopic discectomy showed a slightly longer operation time and shorter incision than open discectomy, but no clinically relevant differences in outcomes.
  • Conflicting results were found when comparing tubular discectomy with microscopic discectomy for back pain and surgical duration.

Conclusions:

  • Limited and low-quality evidence prevents firm conclusions on the effectiveness of current surgical techniques for sciatica due to disc herniation.
  • Observed differences in pain scores, operation time, and incision length are clinically insignificant.
  • Large, high-quality studies are required to assess the effectiveness and cost-effectiveness of these surgical interventions.