Management of Lumbar Postero-lateral Single Level Disc Herniation: Comparative Study Between Conventional and Endoscopic Lumbar Discectomy
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Assiut University
- Enrollment
- 30
- Primary Endpoint
- Functional Improvement
Study Overview
Brief Summary
This study is aimed to compare between the results of conventional lumbar discectomy and the newly used technique in our department; endoscopic lumbar discectomy in neurosurgery department Assiut university hospitals, so that we can offer our patients the best service in an updated and minimally invasive way.
Detailed 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.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to 60 Years (Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
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.
Arms & Interventions
Conventional
Patients in this arm will have conventional open lumbar discectomy operation.
Intervention: Conventional open lumbar discectomy (Procedure)
Endoscopic
Patients in this arm will have Percutaneous Endoscopic Translaminar lumbar discectomy operation using Easy Go system Endoscopy
Intervention: Percutaneous Endoscopic Translaminar lumbar discectomy. (Procedure)
Endoscopic
Patients in this arm will have Percutaneous Endoscopic Translaminar lumbar discectomy operation using Easy Go system Endoscopy
Intervention: Easy Go system Endoscopy (Device)
Outcomes
Primary Outcomes
Functional Improvement
Time Frame: Up to ten months post operative.
Functional Improvement using modified MacNab's criteria
Improvement of Preoperative low back pain and radicular pain.
Time Frame: Up to ten months post operative.
Improvement of preoperative low back pain and radicular pain.Clinical outcomes will be measured using Visual Analogue Scale.
Secondary Outcomes
- Hospital stay.(up to one week.)
- Blood loss(intraoperative.)
- lumbo-sacral MRI(Up to six months)
- Wound length(Intraoperative)
- Operative time(Intraoperative)
- Periprocedural complication.(Up to two weeks.)
Investigators
H A Othman
Resident Doctor, Neurosurgery Department, Assiut Universiy Hosipitals
Assiut University