Comparison Between Conventional vs. Endoscopic Lumbar Discectomy
Keywords
Abstract
Description
Lumbar discectomy is one of the most common operation performed worldwide for lumbar-related symptoms. Lumbar disc herniation accounts for only 5% of all low back pain problems but is the most common cause of radiating nerve root pain, sciatica.
Mixter and Barr described the first surgical procedure to remove the herniated lumbar disc in 1934 through a laminectomy and durotomy, with later enhancement by Semmes, who described approaching the herniated disc through hemilaminectomy and retraction of the dural sac. This became popularized as the "classical discectomy technique.
During the latter half of the 19th century, more techniques were developed to remove the herniated disc with minimal invasiveness. The first herniated disc excision using a microscope (microdiscectomy) was performed by Yasargil in 1977, which was the standard surgical procedure at the time In 1993, Mayer and Brock and then in 1997, Smith and Foley described endoscopic discectomy techniques. With these minimally invasive techniques, authors demonstrated decreased soft tissue manipulation, operative time, blood loss, and hospital stay, allowing early recovery.
In this study we try to evaluate clinical and radiological outcomes of percutaneous endoscopic translaminar discectomy at our hospital.
Dates
| Last Verified: | 11/30/2018 |
| First Submitted: | 04/18/2017 |
| Estimated Enrollment Submitted: | 04/27/2017 |
| First Posted: | 05/01/2017 |
| Last Update Submitted: | 12/16/2018 |
| Last Update Posted: | 12/18/2018 |
| Actual Study Start Date: | 11/30/2016 |
| Estimated Primary Completion Date: | 04/30/2018 |
| Estimated Study Completion Date: | 07/31/2018 |
Condition or disease
Intervention/treatment
Procedure: Conventional
Procedure: Endoscopic
Device: Endoscopic
Phase
Arm Groups
| Arm | Intervention/treatment |
|---|---|
| Active Comparator: Conventional Patients in this arm will have conventional open lumbar discectomy operation. | Procedure: Conventional Removal of single level lumbar disc herniation through conventional discectomy. |
| Active Comparator: Endoscopic Patients in this arm will have Percutaneous Endoscopic Translaminar lumbar discectomy operation using Easy Go system Endoscopy | Procedure: Endoscopic Removal of single level Lumbar disc herniation using endoscope. |
Eligibility Criteria
| Ages Eligible for Study | 18 Years To 18 Years |
| Sexes Eligible for Study | All |
| Accepts Healthy Volunteers | Yes |
| Criteria | Inclusion Criteria: - single level, postero-lateral, denovo lumbar disc herniation including those with migrated and/or sequestrated discs. - L4,5 &L5,S1 disc prolapse - Failure of conservative management after 12 weeks. Exclusion Criteria: - central, far lateral, recurrent and/or multiple level disc herniation. - Lateral recess stenosis or spondylolisthesis. - presence of neurological deficit. |
Outcome
Primary Outcome Measures
1. Improvement of Preoperative low back pain and radicular pain. [Up to ten months post operative.]
2. Functional Improvement [Up to ten months post operative.]
Secondary Outcome Measures
1. Hospital stay. [up to one week.]
2. Periprocedural complication. [Up to two weeks.]
3. Blood loss [intraoperative.]
4. lumbo-sacral MRI [Up to six months]
5. Operative time [Intraoperative]
6. Wound length [Intraoperative]
