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Limited versus Aggressive Open Discectomy for a Single Level Lumbar Intervertebral Disc Prolapse
M K Ahsan1, S I Khan, M M Tarik
1Dr Md Kamrul Ahsan, Associate Professor of Spinal surgery, Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh;
Mymensingh Medical Journal : MMJ
|August 9, 2019
Summary
Limited lumbar discectomy offers comparable outcomes to aggressive discectomy for disc herniation, with better patient satisfaction and reduced operative time. Both methods achieve satisfactory results, making limited discectomy a viable alternative.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Surgery
Background:
- Open lumbar discectomy is the standard surgical treatment for intervertebral disc herniation.
- Debate exists regarding whether limited or aggressive open discectomy yields superior clinical outcomes.
- Comparative studies are needed to evaluate the efficacy and safety of different discectomy approaches.
Purpose of the Study:
- To compare the clinical outcomes, complication rates, and recurrence rates between limited discectomy (LD) and aggressive open discectomy (AD).
- To assess patient satisfaction and identify potential advantages of each surgical technique.
Main Methods:
- Retrospective evaluation of 2380 patients who underwent either limited or aggressive open discectomy.
- Data collected included demographics, surgical details, complications, and re-herniation rates.
- Clinical outcomes were assessed using the Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and modified McNab criteria.
Main Results:
- Limited discectomy demonstrated significantly shorter operative times (55 vs. 95 minutes) and reduced analgesic use compared to aggressive discectomy.
- Patient satisfaction was significantly higher in the limited discectomy group.
- No significant differences were observed in low back pain, leg pain, recurrence rates, infection, blood loss, or hospitalization duration between the groups.
Conclusions:
- Limited lumbar discectomy is a safe and effective alternative to aggressive open discectomy for treating intervertebral disc herniation.
- Both surgical approaches result in satisfactory clinical outcomes, with limited discectomy offering improved patient satisfaction and efficiency.
- The choice between limited and aggressive discectomy may depend on patient-specific factors and surgeon preference, considering the comparable efficacy in key clinical outcomes.
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