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"Lumbar discectomy"

Original Articles

Spine Health Care Analysis

Bracing and Activity Restriction After Lumbar Discectomy Surgery: An International Survey of AO Spine Members
Waeel O. Hamouda, Stipe Ćorluka, Sathish Muthu, Luca Ambrosio, Carla Cunha, Stjepan Ivandic, Mohamed A.R. Soliman, Fabrizio Russo, Sibylle Grad, In Ho Han, Gianluca Vadala, Hans-Jorg Meisel, Sam K. Cho, Tim S. Yoon, Jeffrey C. Wang, Amit Jain, Zorica Buser, AO Spine Knowledge Forum Degenerative
Neurospine 2026;23(1):109-116.   Published online January 31, 2026
DOI: https://doi.org/10.14245/ns.2551622.811

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Bracing and Activity Restriction After Lumbar Discectomy Surgery: An International Survey of AO Spine Members
Neurospine. 2026;23(1):109-116.   Published online January 31, 2026
DOI: https://doi.org/10.14245/ns.2551622.811
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Bracing and Activity Restriction After Lumbar Discectomy Surgery: An International Survey of AO Spine Members
Neurospine. 2026;23(1):109-116.   Published online January 31, 2026
DOI: https://doi.org/10.14245/ns.2551622.811
Close
Objective
Bracing after lumbar discectomy surgery (LDS) is a controversial topic with paucity of related scientific literature. Previous surveys on spine surgeons’ preferences were limited both in geographical coverage and number of respondents. The aim of this study is to fill this gap in the literature.
Methods
An international online survey among AO Spine members regarding the postoperative recommendations for bracing (PoBr), activity restriction (AR), and associated factors, was performed.
Results
A total of 703 spine surgeons participated in the survey of which 34% recommended PoBr, with half of them reported usage for 4 weeks. Main influencing variables were being from Europe/South Africa region, greater extent of bony decompression, and larger amount of excised disc material. Seventy-nine percent of the respondents recommended postoperative AR. Prolonged standing, prolonged sitting, and driving were usually restricted for 2 weeks. Bending, twisting, lifting, and low-intensity physical activities for 3 months, while high-intensity physical activities and direct contact sports for 6 months were restricted.
Conclusion
Despite recent literature insights showing limited evidence of efficacy, 34% and 80% of a large cohort of international surgeons practice bracing and recommend AR after LDS for variable durations. Extensive bony decompression and radical discectomy significantly influenced the decision to brace, similarly endoscopic approaches and radical discectomy influenced the decision to restrict activity. These findings emphasize the persistent evidence-practice gap and the wide variability on the global level. More randomized controlled trials are warranted on this topic to reach an evidence-based recommendation.
  • 2,707 View
  • 93 Download

Minimally Invasive Spine Surgery

Transforaminal Lumbar Endoscopic Discectomy: A Novel Alternative for Management of Lumbar Disc Herniation in Patients With Rheumatoid Arthritis?
Stylianos Kapetanakis, Constantinos Chaniotakis, Paschalis Tsioulas, Nikolaos Gkantsinikoudis
Neurospine 2024;21(4):1210-1218.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2448634.317

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Transforaminal Lumbar Endoscopic Discectomy: A Novel Alternative for Management of Lumbar Disc Herniation in Patients With Rheumatoid Arthritis?
Neurospine. 2024;21(4):1210-1218.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2448634.317
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Transforaminal Lumbar Endoscopic Discectomy: A Novel Alternative for Management of Lumbar Disc Herniation in Patients With Rheumatoid Arthritis?
Neurospine. 2024;21(4):1210-1218.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2448634.317
Close
Objective
Lumbar disc herniation (LDH) represents an increasingly encountered condition in patients with rheumatoid arthritis (RA). The aim of the present study is to assess the progress of health-related quality of life following transforaminal endoscopic lumbar discectomy (TELD) for LDH in patients suffering from RA.
Methods
Seventy-four patients, scheduled to undergo elective TELD for LDH, were prospectively enrolled in the study. Group A included 36 otherwise healthy individuals and group B 38 patients complementarily diagnosed with RA according to the 2010 ACR/EULAR (American College of Rheumatology/European League Against Rheumatism) criteria. The Medical Outcomes Study 36-item Short Form health survey (SF-36) was selected for the outcome assessment at baseline and postoperatively, at selected intervals at 6 weeks, 3, 6, and 12 months postoperatively.
Results
Group A presented statistically significantly higher scores in all SF-36 domains and all selected intervals (p<0.001), except for mental health parameter. All aspects of SF-36 questionnaire significantly improved postoperatively (p<0.001) and in each group independently. Nevertheless, the absolute improvement between consecutive time intervals did not differ significantly between the 2 groups.
Conclusion
Patients diagnosed with RA who undergo TELD for LDH demonstrate statistically significant improvement in their health status, as measured by SF-36 questionnaire, one year after the procedure. This improvement is comparable with normal individuals.

Citations

Citations to this article as recorded by  Crossref logo
  • Full-Endoscopic Lumbar Discectomy: A Review of the Surgical Techniques, Indications and Anatomical Considerations
    Stylianos Kapetanakis, Mikail Chatzivasiliadis, Nikolaos Gkantsinikoudis, Konstantinos Pazarlis
    Journal of Clinical Medicine.2025; 14(24): 8961.     CrossRef
  • 3,754 View
  • 97 Download
  • 1 Web of Science
  • 1 Crossref

Regular Issue

Comparison of Clinical and Radiographic Outcomes Between Transforaminal Endoscopic Lumbar Discectomy and Microdiscectomy: A Follow-up Exceeding 5 Years
Xinyu Yang, Shijun Zhang, Junxiao Su, Sai Guo, Yakubu Ibrahim, Kai Zhang, Yonghao Tian, Lianlei Wang, Suomao Yuan, Xinyu Liu
Neurospine 2024;21(1):303-313.   Published online February 1, 2024
DOI: https://doi.org/10.14245/ns.2347026.513

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Comparison of Clinical and Radiographic Outcomes Between Transforaminal Endoscopic Lumbar Discectomy and Microdiscectomy: A Follow-up Exceeding 5 Years
Neurospine. 2024;21(1):303-313.   Published online February 1, 2024
DOI: https://doi.org/10.14245/ns.2347026.513
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Comparison of Clinical and Radiographic Outcomes Between Transforaminal Endoscopic Lumbar Discectomy and Microdiscectomy: A Follow-up Exceeding 5 Years
Neurospine. 2024;21(1):303-313.   Published online February 1, 2024
DOI: https://doi.org/10.14245/ns.2347026.513
Close
Objective
To compare the long-term clinical and radiographic outcomes of transforaminal endoscopic lumbar discectomy (TELD) versus microdiscectomy (MD).
Methods
The data of 154 patients with lumbar disc herniation (LDH) who underwent TELD (n = 89) or MD (n = 65) were retrospectively analyzed. The patients’ clinical outcomes were evaluated using visual analogue scales for leg and low back pain, the Japanese Orthopaedic Association (JOA) score, and the Oswestry Disability Index (ODI). The evolution of radiographic manifestations was observed during follow-up. Potential risk factors for a poor clinical outcome were investigated.
Results
During a mean follow-up of 5.5 years (range, 5–7 years), the recurrence rate was 4.49% in the TELD group and 1.54% in the MD group. All scores significantly improved from preoperatively to postoperatively in both groups (p < 0.01). The improvement in the ODI and JOA scores was significantly greater in the TELD than MD group (p < 0.05). Forty-seven patients (52.8%) in the TELD group and 32 (49.2%) in the MD group had Modic changes before surgery, most of which showed no changes at the last follow-up. The degeneration grades of 292 discs (71.0%) were unchanged at the last follow-up, while 86 (20.9%) showed improvement, mostly at the upper adjacent segment. No significant difference was observed in the intervertebral height index or paraspinal muscle-disc ratio.
Conclusion
Both TELD and MD provide generally satisfactory long-term clinical outcomes for patients with LDH. TELD can be used as a reliable alternative to MD with less surgical trauma. Modic type II changes, decreased preoperative intervertebral height, and a high body mass index are predictors of a poor prognosis.

Citations

Citations to this article as recorded by  Crossref logo
  • Comparison of the Converging Decompression Technique and Foraminoplasty Percutaneous Transforaminal Endoscopic Discectomy in the Treatment of Very Highly Upward Migrated Lumbar Disc Herniation
    Jianing Yang, Rongbo Yu, Yuyang Zheng, Pengfei Wang, Haitian Zhang, Bin Chen
    World Neurosurgery.2026; 205: 124718.     CrossRef
  • Bracing and Activity Restriction After Lumbar Discectomy Surgery: An International Survey of AO Spine Members
    Waeel O. Hamouda, Stipe Ćorluka, Sathish Muthu, Luca Ambrosio, Carla Cunha, Stjepan Ivandic, Mohamed A.R. Soliman, Fabrizio Russo, Sibylle Grad, In Ho Han, Gianluca Vadala, Hans-Jorg Meisel, Sam K. Cho, Tim S. Yoon, Jeffrey C. Wang, Amit Jain, Zorica Buse
    Neurospine.2026; 23(1): 109.     CrossRef
  • Efficacy of visualized reamer foraminoplasty in transforaminal endoscopic lumbar discectomy: a retrospective controlled study
    Honglin Liu, Yuxiang Hu, Yang Zhan, Zhixin Kang, Zhuoxuan Zhang, Chengyu Huang, Ningjing Zeng, Yang Xiao, Juntao Ma, Zibo Gao, Hao Liu, Guoyi Su, Yongpeng Lin, Zhirong Fan, Dingkun Lin, Yihao Liang, Yongjin Li
    Frontiers in Surgery.2026;[Epub]     CrossRef
  • Comparison of outcomes between unilateral biportal endoscopic discectomy and percutaneous transforaminal endoscopic discectomy in single-level lumbar disc herniation
    Junyang Li, Jianjian Yin, Tao Ma, Jingwei Wu, Xiaoshuang Tu, Luming Nong, Gongming Gao
    Frontiers in Surgery.2026;[Epub]     CrossRef
  • Does Transforaminal Endoscopic Lumbar Discectomy Provide More Value than Microdiscectomy? An Application of the Operative Value Index
    Advith Sarikonda, Adam Leibold, Ashmal Sami, Cheritesh R. Amaravadi, Daniyal Mansoor Ali, Sara Thalheimer, Jack Jallo, Joshua Heller, Srinivas K. Prasad, Ashwini Sharan, James Harrop, Alexander R. Vaccaro, Ahilan Sivaganesan
    Operative Neurosurgery.2025; 29(2): 209.     CrossRef
  • Cost-effectiveness analysis of extended endoscopic lumbar foraminotomy (EELF) and transforaminal lumbar interbody fusion (TLIF): a prospective observational study
    Jun-Hoe Kim, Hangeul Park, Chang-Hyun Lee, Chi Heon Kim
    Scientific Reports.2025;[Epub]     CrossRef
  • Full-endoscopic lumbar spine discectomy: Are We Finally There? A Meta-Analysis of Its Effectiveness Against Non-microscopic Discectomy, Microdiscectomy and Tubular Discectomy
    Kajetan Latka, Klaudia Kozlowska, Kacper Domisiewicz, Tomasz Klepinowski, Dariusz Latka
    The Spine Journal.2025;[Epub]     CrossRef
  • A Commentary on “Far-Lateral Transforaminal Unilateral Biportal Endoscopic Lumbar Discectomy for Upper Lumbar Disc Herniations”
    Jason Pui Yin Cheung
    Neurospine.2025; 22(1): 28.     CrossRef
  • Far-Lateral Transforaminal Unilateral Biportal Endoscopic Lumbar Discectomy for Upper Lumbar Disc Herniations
    Jin Seop Hwang, Sang Hyub Lee, Dain Jeong, Jae-Won Jang, Yong Eun Cho, Dong-Geun Lee, Choon Keun Park, Chung Kee Chough
    Neurospine.2025; 22(1): 14.     CrossRef
  • Acute Spinal Problems in the Elderly
    Joshua Rutnagur, Andrew Frost, Mohit Arora, Jennifer Lowrie, Santosh Baliga
    British Journal of Hospital Medicine.2025; 86(4): 1.     CrossRef
  • Comparison of Clinical and Radiographic Outcomes Between Percutaneous Endoscopic Transforaminal Diskectomy and Unilateral Biportal Endoscopic Diskectomy for the Treatment of L4/5-Level MSU Size-3 Lumbar Disk Herniation: A 2-Year Retrospective Cohort Study
    Rongkun Xu, Liang Wang, Xinyu Yang, Xing Chen, Wenyang Fu, Shangye Li, Xinzhi Zhang, Xinyu Liu, Lianlei Wang
    Neurosurgery.2025; 97(5): 1188.     CrossRef
  • O-arm navigation-based transforaminal unilateral biportal endoscopic discectomy for upper lumbar disc herniation: an innovative preliminary study
    Dong Hyun Lee, Choon Keun Park, Jin-Sung Kim, Jin Sub Hwang, Jin Young Lee, Dong-Geun Lee, Jae-Won Jang, Jun Yong Kim, Yong-Eun Cho, Dong Chan Lee
    Asian Spine Journal.2025; 19(2): 194.     CrossRef
  • A meta-analysis of percutaneous endoscopic discectomy and microdiscectomy for lumbar disc herniation: assessing surgical efficacy and clinical outcomes
    Ahmed M. Taha, Awad Hegab, Mohammed Yousef, Marwan Abdelhakam, Shaimaa Ahmed Dahshan
    Neurological Research.2025; 47(10): 997.     CrossRef
  • Prevalence of Low Back Pain and Functional Disability in Post-Lumbar Laminectomy Patients: A Cross-sectional Study
    Arbab Habib Ullah, Shabi ul Hassan, Arshad Ali, Kainat, Madeeha Khattak, Hammad Farooq
    The Healer Journal of Physiotherapy and Rehabilitation Sciences.2025; 5(1): 209.     CrossRef
  • Clinical outcomes of unilateral biportal endoscopic discectomy for the treatment of far lateral lumbar disc herniation: a retrospective comparative study
    Shuo Yuan, Ziqian Ma, Ruiyuan Chen, Aobo Wang, Yu Xi, Tianyi Wang, Ning Fan, Peng Du, Lei Zang
    BMC Surgery.2025;[Epub]     CrossRef
  • 14,752 View
  • 192 Download
  • 15 Web of Science
  • 15 Crossref
A Modified Laminotomy for Interlaminar Endoscopic Lumbar Discectomy: Technical Report and Preliminary Results
Zhiyun Feng, Yuxu Wu, Honghao Wu, Tae Gyong Jon, Ying Yuan, Zhong Chen, Yue Wang
Neurospine 2023;20(4):1513-1523.   Published online December 31, 2023
DOI: https://doi.org/10.14245/ns.2346572.286

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A Modified Laminotomy for Interlaminar Endoscopic Lumbar Discectomy: Technical Report and Preliminary Results
Neurospine. 2023;20(4):1513-1523.   Published online December 31, 2023
DOI: https://doi.org/10.14245/ns.2346572.286
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A Modified Laminotomy for Interlaminar Endoscopic Lumbar Discectomy: Technical Report and Preliminary Results
Neurospine. 2023;20(4):1513-1523.   Published online December 31, 2023
DOI: https://doi.org/10.14245/ns.2346572.286
Close
Objective
To introduce a technique of laminotomy using a common trephine to enlarge the interlaminar space at L4/5 segment for interlaminar endoscopic lumbar discectomy (IELD) and report the anatomical basis of this procedure, technical details, as well as primary clinical outcomes of a consecutive patient cohort with L4/5 lumbar disc herniation (LDH).
Methods
On anteroposterior fluoroscopy, the intersection of the medial edge of the inferior articular process and the inferior endplate of L4 vertebra was taken as the target. Using a common trephine, laminotomy was performed to remove a big portion of the posterior wall of the canal under the guidance of endoscopy. From June 2018 to December 2021, the consecutive patients who underwent L4/5 IELD were prospectively studied. Clinical outcomes were assessed at the day before surgery, 1 day, 1 month, 3 months, 12 months after surgery, and the last follow-up. Numerical Rating Scale, Roland-Morris Disability Questionnaire (RMDQ), and MacNab criteria were used to evaluate back and leg pain, the quality of life, and clinical efficacy, respectively.
Results
There were 64 men and 44 women, with an age of 50.3 ± 14.9 years. The operating time was 74.54 ± 17.42 minutes. The mean follow-up time was 32.7 ± 18.6 months (range, 12–64 months). The complications of IELD included numbness, neck pain, and recurrence. Both leg pain (6.2 ± 1.9 vs. 1.8 ± 0.8, p < 0.001) and back pain (3.1 ± 2.3 vs. 1.7 ± 0.9, p < 0.001) quickly improved after this procedure and maintained (1.1 ± 1.5, 1.1 ± 1.3) at final follow-up. Physical disability due to back pain, as assessed using RMDQ, was improved remarkably after surgery (15.0 ± 5.8 vs. 2.9 ± 4.1, p < 0.001). In addition, MacNab outcome grade was evaluated as good-to-excellent in 96 cases (88.9%).
Conclusion
A convenient technique of laminotomy using a common trephine was proposed for the L4/5 IELD. It can efficiently enlarge the interlaminar entry to perform endoscopic discectomy. This procedure is particularly suitable for treating LDH with concomitant lumbar spinal stenosis and migrated herniated disc.

Citations

Citations to this article as recorded by  Crossref logo
  • Comparing mid-term outcomes and patient satisfaction between percutaneous endoscopic lumbar discectomy and microendoscopic discectomy for foraminal and extraforaminal lumbar disc herniations: a retrospective matched cohort study
    Sen Liu, Feng Zhao, Chun-Ping Yin, Chao-Hua Zhu, Ruo-Yu Zhao, Guo-Bin Liu, Gang Ji, Jia Chen, Hong-Yang Gao
    Frontiers in Surgery.2025;[Epub]     CrossRef
  • Arthroscopic-assisted uniportal spinal surgery with annular repair for lumbar disc herniation in hemophilia: A case report
    Yaoyu Xiang, Jizheng Li, Xianguang Yang, Fei Sun, Xidan Hu, Tuhaopeng Shen, Jing Yang, Weiqing Ge, Tao Zhou, En Song
    Medicine.2025; 104(29): e42223.     CrossRef
  • Radiographic Anatomy and Clinical Value of the Modified Corner Approach in Interlaminar Endoscopic Lumbar Discectomy
    Sizheng Zhan, Haoning Ma, Yuming Wang, Ping Yi, Xiangsheng Tang
    Orthopaedic Surgery.2025; 17(9): 2640.     CrossRef
  • Enhanced disc regeneration through CRISPR/Cas9-mediated SOX9 and TGFβ1 coexpression in tonsil-derived mesenchymal stromal cells
    Somin Lee, Yerin Yu, Dong hee Kim, Minsung Bock, Yeji Kim, Seong Bae An, Hyemin Choi, Hae Eun Shin, Dong-Youn Hwang, Inbo Han
    Stem Cell Research & Therapy.2025;[Epub]     CrossRef
  • Comparison of efficacy between transforaminal and interlaminar endoscopic discectomy for single-level lumbar disc herniation
    Yu Wang, Jingran Guo, Shan Li, Ye Yuan, Jing Zhao
    Medicine.2025; 104(52): e46711.     CrossRef
  • 7,822 View
  • 473 Download
  • 5 Web of Science
  • 5 Crossref

Technical Note

NASS/Neurospine Endoscopic Spine Surgery Special Issue

A Modified Endoscopic Access for Lumbar Foraminal Pathologies; Posterolateral “Intertransverse” Endoscopic Approach to Minimize Postoperative Dysesthesia Following Transforaminal Approach
Farah N. Musharbash, Sang Hun Lee
Neurospine 2023;20(1):150-157.   Published online March 31, 2023
DOI: https://doi.org/10.14245/ns.2346076.038

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A Modified Endoscopic Access for Lumbar Foraminal Pathologies; Posterolateral “Intertransverse” Endoscopic Approach to Minimize Postoperative Dysesthesia Following Transforaminal Approach
Neurospine. 2023;20(1):150-157.   Published online March 31, 2023
DOI: https://doi.org/10.14245/ns.2346076.038
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A Modified Endoscopic Access for Lumbar Foraminal Pathologies; Posterolateral “Intertransverse” Endoscopic Approach to Minimize Postoperative Dysesthesia Following Transforaminal Approach
Neurospine. 2023;20(1):150-157.   Published online March 31, 2023
DOI: https://doi.org/10.14245/ns.2346076.038
Close
Objective
To present an innovative, modified endoscopic approach for foraminal/extraforaminal pathologies, to reduce postoperative dysesthesia (POD) following the conventional transforaminal endoscopic approach (the access angle more than 45° from the midline), since POD is one of the major documented disadvantages that may compromise patient satisfaction.
Methods
We introduce a modified posterolateral technique, termed the intertransverse approach, utilizing a steeper access angle less than 25° through the intertransversarii muscle and the intertransverse space with expanding Kambin triangle via lateral facetectomy/foraminoplasty, to reduce dorsal root ganglion/exiting nerve root irritation under direct visualization and lower the incidence of POD. Consecutive patients undergoing endoscopic spine surgery via the intertransverse approach for foraminal and/or extraforaminal disc herniations or bony stenosis were retrospectively reviewed. Clinical outcomes were reviewed with the primary outcome being POD.
Results
Twenty-two patients were included in the review. Patients showed significantly improved clinical outcomes (visual analogue scale leg and back pain and Oswestry Disability Index) postoperatively. There was a low rate of dorsal root ganglion (DRG)-related POD (9.1%, 2 of 22) that was minimal and resolved soon.
Conclusion
The inter-transverse endoscopic approach is feasible for lumbosacral foraminal and extraforaminal decompression with significantly improved clinical outcomes and the added advantage of a low rate of DRG-related POD compared to traditionally reported rates in the literature for the conventional transforaminal approach.

Citations

Citations to this article as recorded by  Crossref logo
  • Full-endoscopic trans-pars interarticularis discectomy for foraminal and extraforaminal lumbar disc herniation: surgical technique and early clinical outcomes
    Mohammad Badra, Georges Sakhat, Ahmad Haj Hussein, Ralph Maroun, Ramzi Moucharafieh, Karim Areslan, Youssef Jamaleddine
    Brain and Spine.2026; 6: 106058.     CrossRef
  • The Posterior Oblique Lateral (POL) Full-Endoscopic Approach: A Transverse Process Docking Technique to Avoid Early Neural Contact in Challenging Foraminal and Extraforaminal Pathologies - Technical Note and Illustrative Case Series
    Pornpavit Sriphirom, Akkapong Nitising, Luckchai Phonwijit, Bunpot Sitthinamsuwan, Songrit Vuttipongkul
    Journal of Minimally Invasive Spine Surgery and Technique.2026; 11(Suppl 2): S351.     CrossRef
  • A comparative study of two full-endoscopic foraminoplasty techniques for lumbar disc herniation
    Hengrui Chang, Yuanqing Niu, Yiwen Zhang, Ao Yang, Zhenguo Shang, Di Zhang, Jiaxin Xu
    European Spine Journal.2025; 34(3): 1134.     CrossRef
  • Cost-effectiveness analysis of extended endoscopic lumbar foraminotomy (EELF) and transforaminal lumbar interbody fusion (TLIF): a prospective observational study
    Jun-Hoe Kim, Hangeul Park, Chang-Hyun Lee, Chi Heon Kim
    Scientific Reports.2025;[Epub]     CrossRef
  • Percutaneous endoscopic lumbar discectomy for extreme lateral lumbar disc herniation
    Thomas Luebbers, Albatol Ali, Rainer Baalmann, Aydemir Kale
    Surgical Neurology International.2025; 16: 150.     CrossRef
  • Full-Endoscopic Extraforaminal Approach for Extraforaminal Herniated Intervertebral Disc Disease: Exploring Challenging Case
    Jae Hwan Lee, Kai-Sheng Chang, Li-Wei Sun, Kuo-Tai Chen, Chien-Min Chen
    Journal of Minimally Invasive Spine Surgery and Technique.2024; 9(Suppl 1): S85.     CrossRef
  • Paramedian Unilateral ‘Bitubular’ Endoscopic Access for a Far Lateral Disc Herniation: A Novel Approach for Far Lateral Lumbar Pathologies
    Hui-Ling Kerr, Rohit Wadikhaye, Gyeong Ung Sun, Cheol Woong Park
    Neurospine.2024; 21(4): 1160.     CrossRef
  • Transforaminal Lumbar Endoscopic Discectomy: A Novel Alternative for Management of Lumbar Disc Herniation in Patients With Rheumatoid Arthritis?
    Stylianos Kapetanakis, Constantinos Chaniotakis, Paschalis Tsioulas, Nikolaos Gkantsinikoudis
    Neurospine.2024; 21(4): 1210.     CrossRef
  • 6,391 View
  • 261 Download
  • 6 Web of Science
  • 8 Crossref

Review Article

NASS/Neurospine Endoscopic Spine Surgery Special Issue

Perioperative Management for Full-Endoscopic Lumbar Discectomy: Consideration From the Perspective of Preventing Complication
Takeshi Hara, Yukoh Ohara
Neurospine 2023;20(1):28-32.   Published online March 31, 2023
DOI: https://doi.org/10.14245/ns.2346056.028

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Perioperative Management for Full-Endoscopic Lumbar Discectomy: Consideration From the Perspective of Preventing Complication
Neurospine. 2023;20(1):28-32.   Published online March 31, 2023
DOI: https://doi.org/10.14245/ns.2346056.028
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Perioperative Management for Full-Endoscopic Lumbar Discectomy: Consideration From the Perspective of Preventing Complication
Neurospine. 2023;20(1):28-32.   Published online March 31, 2023
DOI: https://doi.org/10.14245/ns.2346056.028
Close
In recent years, full-endoscopic discectomy (FED) has expanded its range of indications with the development of devices and various techniques. The advantage of FED over conventional surgery is that it is a minimally invasive procedure. However, intraoperative and postoperative precautions must be taken to prevent complications. It is necessary to avoid complications that could compromise the outcome of the procedure. Effective perioperative management is necessary to avoid complications; however, there is no set view for perioperative management in FED. In this study, we perform a literature review to examine the effectiveness of perioperative management methods for FED. The key to ensuring the efficacy and minimal invasiveness of FED is prevention of complications. Based on the result and literature review, we believe that the most manageable postoperative management after FED is prevention of recurrent disc herniation and hematoma formation. A drain should be placed to prevent postoperative hematoma formation. It is advisable to evaluate the patient’s symptoms and monitor C-reactive protein and erythrocyte sedimentation rate levels during the first week after surgery. Postoperative antibiotics were administered for 1 day.

Citations

Citations to this article as recorded by  Crossref logo
  • Efficacy and safety of microendoscopic vs. microlumbar discectomy for patients with double-level lumbar disc prolapse: a randomized clinical trial
    Moamen M. Morsy, Omar B. Nasser, Ayman M. Ismail, Khalid A. Ismail, Ahmed Soliman, Ayman M. Basha
    Interdisciplinary Neurosurgery.2026; 43: 102224.     CrossRef
  • Evaluating the Efficacy and Safety of Hemofence (Thorombin Cross-Linked Sodium Hyaluronate Gel Matrix) in Hemostasis for Intractable Exudative Bleeding in Spinal Surgery: A Multicenter, Randomized, Phase III Clinical Trial
    Sungjae An, Woo-Keun Kwon, Il Choi, Jang-Bo Lee, Joohyun Kim, Junseok W. Hur
    Neurospine.2024; 21(3): 1004.     CrossRef
  • Uniportal Thoracic Endoscopic Unilateral Laminotomy with Bilateral Decompression of Thoracic Ossification of Ligamentum Flavum: A Systematic Review of Current Literature
    Pang Hung Wu, Brian Zhao Jie Chin, Hyeun Sung Kim, Seth Ian Sim, Il-Tae Jang
    World Neurosurgery.2023; 178: 340.     CrossRef
  • Lumbar Endoscopic Unilateral Laminotomy With Bilateral Decompression Surgery in Severe Lumbar Stenosis Under Electrophysiological Monitoring-Focused on Full-Visualized Trephine/Osteotome
    Ning-Ning Dou, Hao-lin Wang, Shao-Zhen Hu, Zheng-Nan Huang, Jun Zhong, Shi-Ting Li
    Neurospine.2023; 20(3): 1040.     CrossRef
  • Near infrared imaging system for preventing blood vision obstruction in endoscopy
    Meng-Huang Wu, Jason C. Hsu, Jin-Sung Kim, Tsung-Jen Huang, Yi-Hung Huang, Hon Pan Yiu, Ching-Yu Lee, Jowy Tani, Cheng-Chun Chang
    Optics Express.2023; 31(26): 43877.     CrossRef
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Original Articles

Minimally Invasive Spinal Surgery SMISS-Neurospine Special Issue

Posterior Apophyseal Ring Fracture in Adult Lumbar Disc Herniation: An 8-Year Experience in Minimally Invasive Surgical Management of 48 Cases
Shuo Yuan, Qichao Wu, Lei Zang, Ning Fan, Peng Du, Aobo Wang, Tianyi Wang, Fangda Si, Jian Li, Xiaochuan Kong
Neurospine 2022;19(3):586-593.   Published online September 30, 2022
DOI: https://doi.org/10.14245/ns.2244346.173

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Posterior Apophyseal Ring Fracture in Adult Lumbar Disc Herniation: An 8-Year Experience in Minimally Invasive Surgical Management of 48 Cases
Neurospine. 2022;19(3):586-593.   Published online September 30, 2022
DOI: https://doi.org/10.14245/ns.2244346.173
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Posterior Apophyseal Ring Fracture in Adult Lumbar Disc Herniation: An 8-Year Experience in Minimally Invasive Surgical Management of 48 Cases
Neurospine. 2022;19(3):586-593.   Published online September 30, 2022
DOI: https://doi.org/10.14245/ns.2244346.173
Close
Objective
Posterior apophyseal ring fracture (PARF) is an uncommon disorder that is usually accompanied by lumbar disc herniation (LDH). The aim of this study to describe the 8-year experience of performing minimally invasive treatment of PARF, giving particular attention to surgical technique and clinical outcome.
Methods
We reviewed 1,324 consecutive patients with LDH seen in our department between 2013 and 2020. Forty-eight patients (3.63%) were enrolled who were diagnosed with PARF associated with LDH and underwent transforminal endoscopic lumbar discectomy (TELD). Mean duration of the final postoperative follow-up was 5.1 years. The control group was comprised of 50 patients diagnosed with LDH without PARF at the same facility. Data on clinical outcomes were analyzed.
Results
The mean operation time in the PARF group was 105.4 minutes, which was longer than the mean operation time of the control group (83.9 minutes) (p = 0.001). Surgical complications, including dural tears (6.3%) and surgical instrument rupture (4.2%) were more common in the PARF group (p = 0.025). However, there was no significant difference in the proportion of excellent and good results and recurrence rates between the LDH patients with and those without PARF, respectively.
Conclusion
TELD is a safe and effective minimally invasive approach for the treatment of PARF. However, minimally invasive techniques may require longer operation time and steeper learning curve for inexperienced surgeons. The separation and removal of bone fragments, a key step in the procedure, requires patience and care to prevent rupture, residual surgical instruments, and leakage of cerebrospinal fluid.

Citations

Citations to this article as recorded by  Crossref logo
  • Research Progress of Minimally Invasive Surgery in the Treatment of Posterior Ring Apophyseal Fracture
    思良 刘
    Journal of Clinical Personalized Medicine.2025; 04(01): 572.     CrossRef
  • Response to “comment on the article by Wang et al.: clinical outcome of percutaneous endoscopic lumbar decompression in treatment of elderly patients with lumbar spinal stenosis: a matched retrospective study”
    Tianyi Wang, Lei Wang, Ning Fan, Shuo Yuan, Peng Du, Fangda Si, Aobo Wang, Lei Zang
    International Orthopaedics.2024; 48(2): 611.     CrossRef
  • The Method of Portal Making in Lumbar Unilateral Biportal Endoscopic Surgery with Different Operative Approaches According to the Constant Anatomical Landmarks of the Lumbar Spine: A Review of the Literature
    Yixi Wang, Abulikemu Maimaiti, Abudusalamu Tuoheti, Yang Xiao, Rui Zhang, Alafate Kahaer, Dongshan Liu, Paerhati Rexiti
    Global Spine Journal.2024; 14(6): 1838.     CrossRef
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    A. Madhavan, R. Siripurapu, A. Herwadkar
    Clinical Radiology.2023; 78(7): 484.     CrossRef
  • Prodrome to Seizure in Transforaminal Endoscopic Surgery: A Series of 9 Cases
    Ajay Krishnan, Vikrant Chauhan, Devanand Degulmadi, Shivanand Mayi, Ravi Ranjan, Mirant B Dave, Shiv Kumar Bali, Pranav Ravi Charde, Abhijith Anil, Preety A Krishnan, Bharat R Dave
    Journal of Minimally Invasive Spine Surgery and Technique.2023; 8(1): 105.     CrossRef
  • Spatiotemporal Gait Parameters and Gait Asymmetry in Patients With Lumbar Disc Herniation, Treated With Microdiscectomy: A Prospective, Observational Study
    Masoud Amir Rashedi Bonab, Suleyman Sener, Tugba Kuru Colak, Mahsa Amirrashedi, Ipek Yeldan, Deniz Konya, Zafer Orkun Toktas
    Neurospine.2023; 20(3): 947.     CrossRef
  • 8,302 View
  • 252 Download
  • 6 Web of Science
  • 6 Crossref
Patient Health Questionnaire-9 Is a Valid Assessment for Depression in Minimally Invasive Lumbar Discectomy
Conor P. Lynch, Elliot D.K. Cha, Nathaniel W. Jenkins, James M. Parrish, Cara E. Geoghegan, Caroline N. Jadczak, Shruthi Mohan, Kern Singh
Neurospine 2021;18(2):369-376.   Published online June 30, 2021
DOI: https://doi.org/10.14245/ns.2142162.031

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Patient Health Questionnaire-9 Is a Valid Assessment for Depression in Minimally Invasive Lumbar Discectomy
Neurospine. 2021;18(2):369-376.   Published online June 30, 2021
DOI: https://doi.org/10.14245/ns.2142162.031
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Patient Health Questionnaire-9 Is a Valid Assessment for Depression in Minimally Invasive Lumbar Discectomy
Neurospine. 2021;18(2):369-376.   Published online June 30, 2021
DOI: https://doi.org/10.14245/ns.2142162.031
Close
Objective
The Patient Health Questionnaire-9 (PHQ-9) is a screening tool for evaluating depressive symptoms. Research is scarce regarding the validity and correlation of PHQ-9 scores with other patient-reported outcomes of mental health after minimally invasive lumbar discectomy (MIS LD). We aim to validate PHQ-9 as a metric for assessing mental health in MIS LD patients.
Methods
A database was retrospectively reviewed for patients who underwent elective, single-level MIS LD. Patients were excluded if they had incomplete preoperative PHQ-9, 12-item Short Form Health Survey (SF-12), or Veterans RAND 12-item health survey (VR12). Survey scores were collected preoperatively and postoperatively through 1 year. Mean scores were used to calculate postoperative improvement from preoperative scores. Correlation of PHQ-9 with SF-12 mental composite score (MCS) and VR-12 MCS scores was also calculated. Correlation strength was assessed by the following categories: 0.1 ≤ |r| < 0.3 = low; 0.3 ≤ |r| < 0.5 = moderate; |r| ≥ 0.5 = strong.
Results
A total of 239 patients underwent single-level MIS LD. PHQ-9, VR-12 MCS, and SF-12 MCS all demonstrated statistically significant increases from preoperative scores at all postoperative timepoints (p ≤ 0.001). SF-12 MCS and VR-12 MCS were each observed to have strong and significant correlations with PHQ-9 at all timepoints when evaluated with both Pearson correlation coefficients and partial correlation coefficients.
Conclusion
We observed that PHQ-9, SF-12 MCS and VR-12 MCS all significantly improve following lumbar discectomy and that PHQ-9 scores strongly correlated with these previously established measures. Our results substantiate evidence from other surgical fields that PHQ-9 scores are a valid tool to evaluate pre- and postsurgical depressive symptoms.

Citations

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    Ellen O’Callaghan, Chinelo Agwuegbo, Maria Junaid, Ezinne Oguguo, Emily Luo, Dana Rowe, Antoinette Charles, Seeley Yoo, Alyssa Bartlett, Samantha J. Kaplan, Melissa Erickson, C. Rory Goodwin
    Clinical Spine Surgery.2026;[Epub]     CrossRef
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    Xing-chen Zhou, Shuang Wu, Kai-zheng Wang, Long-hao Chen, Zi-cheng Wei, Tao Li, Zi-han Hua, Yuan-shen Huang, Qiong Xia, Zhi-zhen Lv, Li-jiang Lv
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    Prerana Katiyar, Justin Reyes, Josephine Coury, Joseph Lombardi, Zeeshan Sardar
    Spine.2024; 49(5): 304.     CrossRef
  • Prognostic Value in Preoperative Veterans RAND-12 Mental Component Score on Clinical Outcomes for Patients Undergoing Minimally Invasive Lateral Lumbar Interbody Fusion
    Ishan Khosla, Fatima N. Anwar, Andrea M. Roca, Srinath S. Medakkar, Alexandra C. Loya, Keith R. MacGregor, Omolabake O. Oyetayo, Eileen Zheng, Aayush Kaul, Jacob C. Wolf, Vincent P. Federico, Gregory D. Lopez, Arash J. Sayari, Kern Singh
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    Brandon J. Toll, Yagiz U. Yolcu, Joel Z. Passer, Andrew Y. Yew, Subu N. Magge, Zoher Ghogawala, Robert G. Whitmore
    World Neurosurgery.2024; 186: e391.     CrossRef
  • Serum calcium improves the relationship between fluoride exposure and hypothalamic-pituitary-testicular axis hormones levels in males—a cross-sectional study on farmers in the lower reaches of the Yellow River
    Guoqing Wang, Leizhen Duan, Yuhui Du, Xiaoli Fu, Bin Liu, Xuanyin Zhang, Fangfang Yu, Guoyu Zhou, Yue Ba
    Environmental Pollution.2024; 363: 125084.     CrossRef
  • Default mode network and dorsal attentional network connectivity changes as neural markers of spinal manipulative therapy in lumbar disc herniation
    Xing-chen Zhou, Shuang Wu, Kai-zheng Wang, Long-hao Chen, Shuang-wei Hong, Yu Tian, Hui-jie Hu, Jia Lin, Zi-cheng Wei, Yun-xing Xie, Zi-hui Yin, Zhi-zhen Lv, Li-jiang Lv
    Scientific Reports.2024;[Epub]     CrossRef
  • Patient Satisfaction Following Lumbar Decompression: What is the Role of Mental Health?
    Madhav R. Patel, Kevin C. Jacob, Timothy J. Hartman, James W. Nie, Vivek P. Shah, Frank A. Chavez, Nisheka N. Vanjani, Conor P. Lynch, Elliot D.K. Cha, Michael C. Prabhu, Hanna Pawlowski, Kern Singh
    World Neurosurgery.2022; 164: e540.     CrossRef
  • Changing lung function and associated health-related quality-of-life: A five-year cohort study of Malawian adults
    Martin W. Njoroge, Patrick Mjojo, Catherine Chirwa, Sarah Rylance, Rebecca Nightingale, Stephen B. Gordon, Kevin Mortimer, Peter Burney, John Balmes, Jamie Rylance, Angela Obasi, Louis W. Niessen, Graham Devereux
    eClinicalMedicine.2021; 41: 101166.     CrossRef
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  • 9 Crossref
Comparison of the Safety and Effectiveness of Percutaneous Endoscopic Lumbar Discectomy for Treating Lumbar Disc Herniation Under Epidural Anesthesia and General Anesthesia
Zhiqiang Ren, Shenghua He, Jiao Li, Yeguang Wang, Juyi Lai, Zhitao Sun, Hualong Feng, Jian Wang
Neurospine 2020;17(1):254-259.   Published online February 1, 2020
DOI: https://doi.org/10.14245/ns.1938366.183

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Comparison of the Safety and Effectiveness of Percutaneous Endoscopic Lumbar Discectomy for Treating Lumbar Disc Herniation Under Epidural Anesthesia and General Anesthesia
Neurospine. 2020;17(1):254-259.   Published online February 1, 2020
DOI: https://doi.org/10.14245/ns.1938366.183
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Comparison of the Safety and Effectiveness of Percutaneous Endoscopic Lumbar Discectomy for Treating Lumbar Disc Herniation Under Epidural Anesthesia and General Anesthesia
Neurospine. 2020;17(1):254-259.   Published online February 1, 2020
DOI: https://doi.org/10.14245/ns.1938366.183
Close
Objective
To assess the safety and effectiveness of percutaneous endoscopic lumbar discectomy (PELD) under epidural anesthesia (EA) and general anesthesia (GA) for treating lumbar disc herniation (LDH).
Methods
A retrospective study involving 86 patients with LDH managed by PELD under EA and GA was conducted from July 2018 to March 2019. These patients were divided into 2 groups according to the type of anesthesia. Patient’s demographics data as well as the operation time, complications, fluoroscopy shots, visual analog scale (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA), and MacNab scores of the 2 groups were recorded. All of the patients were followed-up at 6 months after operation.
Results
There were no significant differences were detected in the preoperative demographics between the groups (p > 0.05). Two cases (4.8%) under GA developed transient motor weakness, 3 cases (7.4%) presented numbness of lower limb, and 1 case (2.4%) had cauda equina syndrome after operation. In EA group, 1 case (2.2%) had motor weakness and 3 cases (6.7%) had lower limb numbness, which resolved completely at the last follow-up. There was significant difference between preoperative VAS, JOA, and ODI scores and postoperative scores (p < 0.01). Moreover, there were no differences in the operation time, fluoroscopy shots, and MacNab scores between the 2 groups (p > 0.05).
Conclusion
EA and GA in PELD are effective and safe, and no significant difference in complications was observed. Based on our experience, we recommended junior surgeons to perform PELD under EA for getting feedback from the patient to avoid nerve injury and reduce the radiation dose. The concentration of ropivacaine in EA should be considered carefully.

Citations

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  • Clinical Outcomes of Open, Tubular, and Endoscopic Lumbar Discectomy
    Dillon H. Stone, Garrison P. Bentz, John O’Malley, Lane McCoy, Anshum Sood, Salim Yakdan, Camilo A. Molina, Jacob Buchowski, John C. Clohisy, Jacob K. Greenberg, Brian J. Neuman, Keith Bridwell, Blake K. Montgomery, Karan Joseph, Benjamin Plog, Lucas Budd
    Spine Open.2026;[Epub]     CrossRef
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    Takafumi Ohshima, Takayuki Kitahara, Seiya Watanabe, Saori Soeda, Daiki Nakajima, Hiroshi Kageyama, Masatoshi Morimoto, Hiroaki Manabe, Fumitake Tezuka, Junzo Fujitani, Atsushi Teramoto, Koichi Sairyo, KOICHIRO ONO
    PLOS One.2026; 21(5): e0349672.     CrossRef
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    Haris Ali, Mehboob Alam, Sohail Ahmad
    Pakistan Journal of Health Sciences.2026; : 137.     CrossRef
  • Ultrasound-guided erector spinae plane block for awake spine surgery: A case report and review of the literature
    Ashwini Reddy, Amiya K. Barik, Nidhi Bhatia, Kajal Jain
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  • Determining the Maximum Tolerable Concentration of Ropivacaine to Maintain Sensation of the Nerve Root in Percutaneous Endoscopic Transforaminal Lumbar Discectomy: Can Epidural Anaesthesia Achieve Pain-Tactile Separation Block to Avoid Nerve Injury?
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    木然·阿布都克力木 依
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    James Mooney, Nicholas Laskay, Nicholas Erickson, Arsalaan Salehani, Anil Mahavadi, Adeel Ilyas, Bipul Mainali, Błażej Nowak, Jake Godzik
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    Vit Kotheeranurak, Wongthawat Liawrungrueang, Javier Quillo-Olvera, Christoph J. Siepe, Zhen Zhou Li, Pramod V. Lokhande, Gun Choi, Yong Ahn, Chien-Min Chen, Kyung-Chul Choi, Facundo Van Isseldyk, Vincent Hagel, Sairyo Koichi, Christoph P. Hofstetter, Dav
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    Ankush I. Bajaj, Natalie Yap, Peter B. Derman, Sanjay Konakondla, Osama N. Kashlan, Albert E. Telfeian, Christoph P. Hofstetter
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The Role of Full-Endoscopic Lumbar Discectomy in Surgical Treatment of Recurrent Lumbar Disc Herniation: A Health-Related Quality of Life Approach
Stylianos Kapetanakis, Nikolaos Gkantsinikoudis, Georgios Charitoudis
Neurospine 2019;16(1):96-104.   Published online March 31, 2019
DOI: https://doi.org/10.14245/ns.1836334.167

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The Role of Full-Endoscopic Lumbar Discectomy in Surgical Treatment of Recurrent Lumbar Disc Herniation: A Health-Related Quality of Life Approach
Neurospine. 2019;16(1):96-104.   Published online March 31, 2019
DOI: https://doi.org/10.14245/ns.1836334.167
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The Role of Full-Endoscopic Lumbar Discectomy in Surgical Treatment of Recurrent Lumbar Disc Herniation: A Health-Related Quality of Life Approach
Neurospine. 2019;16(1):96-104.   Published online March 31, 2019
DOI: https://doi.org/10.14245/ns.1836334.167
Close
Objective
To investigate the utility of full-endoscopic lumbar discectomy (FELD) in surgical treatment of recurrent lumbar disc herniation (RLDH).
Methods
Forty-five patients were prospectively studied. All patients were subjected to FELD for RLDH. They were assessed preoperatively and in regular intervals at 6 weeks and 3 months, 6 months, and 12 months postoperatively. Evaluation was conducted with visual analogue scale for leg (VAS-LP) and low back (VAS-BP) pain. Short-Form 36 Health Survey Questionnaire was utilized for health-related quality of life assessment.
Results
All studied parameters featured statistically significant amelioration at all follow-up intervals. Maximal improvement was in general at 6 weeks observed, with subsequent lesser improvement until 6 months and stabilization until the end of follow-up. Comparative assessment indicated that VAS-BP displayed quantitatively lower improvement, whereas physical function, bodily pain, and role-emotional parameters demonstrated greater amelioration.
Conclusion
FELD is associated with a favorable impact in postoperative daily life of patients with RLDH.

Citations

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    Moamen M. Morsy, Omar B. Nasser, Ayman M. Ismail, Khalid A. Ismail, Ahmed Soliman, Ayman M. Basha
    Interdisciplinary Neurosurgery.2026; 43: 102224.     CrossRef
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    Yongsheng Ye, Yonghong Feng, Cailiang Cai, Xuefei Zhang, Henian Li, Binshan Zhang, Jianqiu Chen, Shabin Zhuang, Fangyue Deng
    PeerJ.2026; 14: e21081.     CrossRef
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    Marc Szadkowski, Xavier Castel, Jean Baptiste Odent, Elie Saghbini, Anuj Gupta, Sebastien Pinon, Thais Dutra Vieira, Henri d'Astorg
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    Stylianos Kapetanakis, Krikor Gkoumousian, Nikolaos Gkantsinikoudis, Constantinos Chaniotakis
    Asian Spine Journal.2025; 19(1): 94.     CrossRef
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    Pang Hung Wu, Rohit Akshay Kavishwar, Hyeun Sung Kim
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    Xavier Castel, Henri d’Astorg, Thais Dutra Vieira, Marc Szadkowski
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    Sachi Jain, Sandeep Shinde, Pooja Jain
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    Stylianos Kapetanakis, Nikolaos Gkantsinikoudis, Sotirios Apostolakis, Paschalis Tsioulas, Constantinos Chaniotakis
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    Stylianos Kapetanakis, Constantinos Chaniotakis, Periklis Zavridis, Periklis Kopsidas, Sotirios Apostolakis, Nikolaos Gkantsinikoudis
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    Loïc de Nijs, Edward Fomekong, Christian Raftopoulos
    World Neurosurgery.2023; 173: e401.     CrossRef
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    Hyeun Sung Kim, Pang Hung Wu, Il-Tae Jang
    Journal of Korean Neurosurgical Society.2023; 66(4): 344.     CrossRef
  • Moderate to Severe Multifidus Fatty Atrophy is the Risk Factor for Recurrence After Microdiscectomy of Lumbar Disc Herniation
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  • 25 Web of Science
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Clinical Articles

Efficacy and Safety of Sodium Hyaluronate with 1,4-Butanediol Diglycidyl Ether Compared to Sodium Carboxymethylcellulose in Preventing Adhesion Formation after Lumbar Discectomy
Gyu Yeul Ji, Chang Hyun Oh, Byung Gwan Moon, Seong Yi, In Bo Han, Dong Hwa Heo, Ki-Tack Kim, Dong Ah Shin, Keung Nyun Kim
Korean J Spine 2015;12(2):41-47.   Published online June 30, 2015
DOI: https://doi.org/10.14245/kjs.2015.12.2.41

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Efficacy and Safety of Sodium Hyaluronate with 1,4-Butanediol Diglycidyl Ether Compared to Sodium Carboxymethylcellulose in Preventing Adhesion Formation after Lumbar Discectomy
Korean J Spine. 2015;12(2):41-47.   Published online June 30, 2015
DOI: https://doi.org/10.14245/kjs.2015.12.2.41
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Efficacy and Safety of Sodium Hyaluronate with 1,4-Butanediol Diglycidyl Ether Compared to Sodium Carboxymethylcellulose in Preventing Adhesion Formation after Lumbar Discectomy
Korean J Spine. 2015;12(2):41-47.   Published online June 30, 2015
DOI: https://doi.org/10.14245/kjs.2015.12.2.41
Close
Objective

Epidural injection of hyaluronic acid may prevent adhesion formation after spine surgery, but the compounds used to stabilize hyaluronidase could interfere with its anti-adhesion effects. The present study was conducted as a clinical trial to evaluate the efficacy and safety of an experimental medical gel in preventing adhesion formation.

Methods

This study was designed as a multicenter, randomized, double-blind, and comparative controlled clinical trial with an observation period of 6 weeks. Subjects were randomly assigned into two groups: group A with sodium hyaluronate + 1,4-butanediol diglycidyl ether (BDDE) and group B with sodium hyaluronate + sodium carboxymethylcellulose (CMC). Visual analogue scale (VAS) of back and leg pain and the Oswestry disability index (ODI) and scar score ratings were assessed after surgery.

Results

Mean scar grade was 2.37±1.13 in group A and 2.75±0.97 in group B, a statistically significant difference (p=0.012). VAS of back and leg pain and ODI scores decreased significantly from baseline to 3 and 6 weeks postoperatively in both groups (p<0.001). However, VAS and ODI scores were not statistically different between groups A and B at baseline or at 3 and 6 weeks after operation (p>0.3). The number of adverse reactions related to the anti-adhesion gels was not statistically different (p=0.569), but subsequent analysis of nervous adverse reactions showed group B was superior with a statistically difference (p=0.027).

Conclusion

Sodium hyaluronate with BDDE demonstrated similar anti-adhesion properties to sodium hyaluronate with CMC. But, care should be used to nervous adverse reactions by using sodium hyaluronate with BDDE.

Citations

Citations to this article as recorded by  Crossref logo
  • Are We Overlooking Harms of BDDE-Cross-Linked Dermal Fillers? A Scoping Review
    Marta Wojtkiewicz, Albert Stachura, Bartłomiej Roszkowski, Natalia Winiarska, Karolina Kazimierska, Kamilla Stachura
    Aesthetic Plastic Surgery.2024; 48(23): 5147.     CrossRef
  • Evaluation of the optimal dose for maximizing the anti-adhesion performance of a self-degradable dextran-based material
    Woogi Hyon, Suong-Hyu Hyon, Kazuaki Matsumura
    Carbohydrate Polymer Technologies and Applications.2022; 4: 100255.     CrossRef
  • MORPHOLOGICAL PATTERNS OF DEVELOPMENT AND PREVENTION OF EXPERIMENTAL EPIDURAL FIBROSIS
    I.A. SHURYGINA, A.P. ZHIVOTENKO, O.A. GOLDBERG, V.A. SOROKOVIKOV
    AVICENNA BULLETIN.2022; 24(2): 176.     CrossRef
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    I. G. Krasivina, L. N. Dolgova, N. V. Dolgov
    Meditsinskiy sovet = Medical Council.2021; (10): 123.     CrossRef
  • Using cross-linked hyaluronic acid gel to prevent postoperative lumbar epidural space adhesion: in vitro and in vivo studies
    Kun Wang, Xiao long Li, Jinbo Liu, Xiaoliang Sun, Huilin Yang, Xin Gao
    European Spine Journal.2020; 29(1): 129.     CrossRef
  • Antiadhesion effect of the C17 glycerin ester of isoprenoid-type lipid forming a nonlamellar liquid crystal
    Takahide Murakami, Ichiro Hijikuro, Kota Yamashita, Shigeru Tsunoda, Kenjiro Hirai, Takahisa Suzuki, Yoshiharu Sakai, Yasuhiko Tabata
    Acta Biomaterialia.2019; 84: 257.     CrossRef
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    Wei Wu, Ruoyu Cheng, José das Neves, Jincheng Tang, Junyuan Xiao, Qing Ni, Xinnong Liu, Guoqing Pan, Dechun Li, Wenguo Cui, Bruno Sarmento
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    Chialin Sheu, K. T. Shalumon, Chih-Hao Chen, Chang-Yi Kuo, Yi Teng Fong, Jyh-Ping Chen
    Journal of Materials Chemistry B.2016; 4(41): 6680.     CrossRef
  • 12,325 View
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  • 10 Crossref
Does Obesity Make an Influence on Surgical Outcomes Following Lumbar Microdiscectomy?
Min-Wook Yoo, Seung-Jae Hyun, Ki-Jeong Kim, Tae-Ahn Jahng, Hyun-Jib Kim
Korean J Spine 2014;11(2):68-73.   Published online June 30, 2014
DOI: https://doi.org/10.14245/kjs.2014.11.2.68

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Does Obesity Make an Influence on Surgical Outcomes Following Lumbar Microdiscectomy?
Korean J Spine. 2014;11(2):68-73.   Published online June 30, 2014
DOI: https://doi.org/10.14245/kjs.2014.11.2.68
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Does Obesity Make an Influence on Surgical Outcomes Following Lumbar Microdiscectomy?
Korean J Spine. 2014;11(2):68-73.   Published online June 30, 2014
DOI: https://doi.org/10.14245/kjs.2014.11.2.68
Close
Objective

The purpose of this study was to evaluate the effect of patients' bod mass index (BMI) on surgical outcomes following one-level lumbar microdiscectomy.

Methods

From June 2003 to March 2007, 129 patients underwent one-level lumbar microdiscectomy performed at a single institution. We divided the patients into 3 groups, depending on BMI. A retrospective study was conducted among the 3 groups. The operation time, estimated blood loss (EBL), postoperative hospital day, recurrent disc herniation, intraoperative durotomy, and postoperative epidural steroid injection were analyzed. Regression models were used to predict the relationship between BMI and surgical outcomes including operation time and EBL.

Results

As BMI is greater, as the operation time is longer and the EBL is more. In particular, linear regression model analysis implied that 2.35 minute in the operation time is longer and 8.89cc in EBL is more, as BMI of 1 kg/m2 is increased. No statistically relevant differences were observed for postoperative hospital day, recurrent disc herniation, intraoperative durotomy, and postoperative epidural steroid injection.

Conclusion

The operation time and EBL was significantly increased in obesity, but there were no differences in surgical outcomes. Our results demonstrated that higher BMI are not likely to encounter heightened morbidity in lumbar microdiscectomy.

Citations

Citations to this article as recorded by  Crossref logo
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    Maia Finkelstein Fell, Gabriel Fieraru, Himanshu Sharma
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    Reuben Christopher, Marian Suresh, Amr Badary, Piotr Zelenkov, Jens Lehmberg, Ehab Shiban
    Brain and Spine.2026; 6: 105948.     CrossRef
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    Dillon H. Stone, John O’Malley, Lane McCoy, Garrison P. Bentz, Kayode Matthew, Bradley Nelson, Lucas Budd, Pallavi Jonnalagadda, Salim Yakdan, Mark A. Feger, Brian Neuman, Jacob Buchowski, John Ogunlade, Mark J. Lambrechts
    Journal of Clinical Neuroscience.2026; 153: 112213.     CrossRef
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    Parth Bansal, Arvind Janardhan Vatkar, Vishnu Baburaj, Vishal Kumar, Sarvdeep Singh Dhatt
    Archives of Orthopaedic and Trauma Surgery.2023; 143(9): 5589.     CrossRef
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    Phillip Vorster, Abhijith V. Matur, Paolo Palmisciano, Fatu S. Conteh, Louisa Onyewadume, Henry O. Duah, Geet G. Shukla, Sai S. Chilakapati, Xu Tao, Sahil Gupta, Sanjit Shah, Benjamin Motley, Joseph Cheng, Justin Virojanapa, Owoicho Adogwa
    World Neurosurgery.2023; 175: 122.     CrossRef
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    Jun-Young Choi, Hyun-Jin Park, Sang-Min Park, Ki-Han You, Min-Seok Kang, Jae-Yeon Hwang, Joon-Hyeok Yoon, Ho-Joong Kim, Jin S. Yeom
    Acta Neurochirurgica.2023; 165(9): 2641.     CrossRef
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    Anas Abdallah, Erhan Emel, Betül Güler Abdallah
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    Niyaz Hareni, Fredrik Strömqvist, Björn E. Rosengren, Magnus K. Karlsson
    BMC Musculoskeletal Disorders.2022;[Epub]     CrossRef
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    Jenny C. Kienzler, Volkmar Heidecke, Richard Assaker, Javier Fandino, Martin Barth
    Acta Neurochirurgica.2021; 163(2): 545.     CrossRef
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    Jenny C. Kienzler, Javier Fandino, Erik Van de Kelft, Sandro Eustacchio, Gerrit Joan Bouma
    Acta Neurochirurgica.2021; 163(1): 259.     CrossRef
  • Impact of Obesity on Complication Rates, Clinical Outcomes, and Quality of Life after Minimally Invasive Transforaminal Lumbar Interbody Fusion
    Lukas Goertz, Pantelis Stavrinou, Christina Hamisch, Moritz Perrech, Dierk-Marko Czybulka, Kaveh Mehdiani, Marco Timmer, Roland Goldbrunner, Boris Krischek
    Journal of Neurological Surgery Part A: Central European Neurosurgery.2021; 82(02): 147.     CrossRef
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    Ahmed Taha, Mohamed Youssef
    Open Journal of Modern Neurosurgery.2020; 10(01): 157.     CrossRef
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    Steven J. McAnany, Samuel C. Overley, Muhammad A. Anwar, Holt S. Cutler, Javier Z. Guzman, Jun S. Kim, Robert K. Merrill, Samuel K. Cho, Andrew C. Hecht, Sheeraz A. Qureshi
    Global Spine Journal.2018; 8(1): 11.     CrossRef
  • Lumbar Microdiscectomy in Obese Patients: A Multicenter Observational Study
    Mattis A. Madsbu, Lise R. Øie, Øyvind Salvesen, Vetle Vangen-Lønne, Øystein P. Nygaard, Tore K. Solberg, Sasha Gulati
    World Neurosurgery.2018; 110: e1004.     CrossRef
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    World Neurosurgery.2018; 119: e666.     CrossRef
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    Junming Cao, Lingde Kong, Fantao Meng, Yingze Zhang, Yong Shen
    Journal of Clinical Neuroscience.2016; 28: 1.     CrossRef
  • 9,537 View
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