Is Microendoscopic Discectomy Effective for Patients With Concomitant Lumbar Disc Herniation and Spondylolysis?

被引:12
作者
Oshima, Yasushi [1 ]
Inanami, Hirohiko [2 ]
Iwai, Hiroki [2 ]
Koga, Hisashi [2 ]
Takano, Yuichi [2 ]
Oshina, Masahito [1 ]
Oka, Hiroyuki [3 ]
Tanaka, Sakae [1 ]
机构
[1] Univ Tokyo, Tokyo, Japan
[2] Iwai Orthopaed Med Hosp, Tokyo, Japan
[3] Univ Tokyo, 22nd Century Med & Res Ctr, Tokyo, Japan
基金
日本学术振兴会;
关键词
fusion; slip; spondylolisthesis; minimally invasive surgery; disc hernia; endoscope; DIRECT REPAIR; SPONDYLOLISTHESIS; DEGENERATION; OUTCOMES; PAIN;
D O I
10.1177/2192568219868970
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study Design: A retrospective cohort study. Objective: Although it is controversial whether to choose only discectomy or fusion surgery in patients with disc herniation and spondylolysis, we expected that aggravation of the spondylolysis may be prevented if posterior supporting muscles can be well-preserved without extensive exploration. The purpose of this study was to investigate the influence of L5 spondylolysis on surgical outcomes following microendoscopic discectomy (MED) in patients with concomitant lumbar disc herniation and spondylolysis. Methods: We reviewed 811 patients who underwent MED for L4/5 or L5/S1 disc herniation. Patients with spondylolisthesis were excluded. We compared surgical outcomes of patients with and without L5 spondylolysis, whose age, sex, and surgical level were matched. Results: A total of 655 patients (80.7%) with complete data were considered eligible for the study. MED was performed at L4/5 and L5/S1 in 338 and 317 patients, respectively. A total of 20 patients (3.1%) had concomitant L5 spondylolysis and disc herniation at L4/5 (9 patients) or L5S1 (11 patients). As we compared each outcome of the 20 patients having L5 spondylolysis with 40 matched patients without L5 spondylosis, there were no significant differences in preoperative or postoperative outcomes between the 2 groups, and no patient with spondylolysis had undergone additional surgery during the mean follow-up period of 24 months. Conclusions: MED demonstrated good surgical results regardless of the presence or absence of spondylolysis. In patients with sciatica with concomitant disc herniation and spondylolysis, but without spondylolisthesis, fusion surgery may not be always necessary.
引用
收藏
页码:700 / 705
页数:6
相关论文
共 32 条
  • [1] Systematic review of observational studies reveals no association between low back pain and lumbar spondylolysis with or without isthmic spondylolisthesis
    Andrade, Nicholas S.
    Ashton, Carol M.
    Wray, Nelda P.
    Brown, Curtis
    Bartanusz, Viktor
    [J]. EUROPEAN SPINE JOURNAL, 2015, 24 (06) : 1289 - 1295
  • [2] Computed tomography evaluation of spondylolysis and spondylolisthesis in asymptomatic patients
    Belfi, Lily M.
    Ortiz, A. Orlando
    Katz, Douglas S.
    [J]. SPINE, 2006, 31 (24) : E907 - E910
  • [3] The natural history of spondylolysis and spondylolisthesis - 45-year follow-up evaluation
    Beutler, WJ
    Fredrickson, BE
    Murtland, A
    Sweeney, CA
    Grant, WD
    Baker, D
    [J]. SPINE, 2003, 28 (10) : 1027 - 1035
  • [4] Unsuccessful Percutaneous Endoscopic Lumbar Discectomy: A Single-Center Experience of 10 228 Cases
    Choi, Kyung-Chul
    Lee, June-Ho
    Kim, Jin-Sung
    Sabal, Luigi Andrew
    Lee, Sol
    Kim, Ho
    Lee, Sang-Ho
    [J]. NEUROSURGERY, 2015, 76 (04) : 372 - 380
  • [5] Microendoscopic decompression for cervical spondylotic myelopathy
    Dahdaleh, Nader S.
    Wong, Albert P.
    Smith, Zachary A.
    Wong, Ricky H.
    Lam, Sandi K.
    Fessler, Richard G.
    [J]. NEUROSURGICAL FOCUS, 2013, 35 (01)
  • [6] Disc degeneration in patients with lumbar spondylolysis
    Dai, LY
    [J]. JOURNAL OF SPINAL DISORDERS, 2000, 13 (06): : 478 - 486
  • [7] Deutman R, 1995, Eur Spine J, V4, P136, DOI 10.1007/BF00298235
  • [8] Minimally invasive cervical microendoscopic foraminotomy: An initial clinical experience
    Fessler, RG
    Khoo, LT
    [J]. NEUROSURGERY, 2002, 51 (05) : S37 - S45
  • [9] Foley K T, 1999, Neurosurg Focus, V7, pe5
  • [10] RADIATING LEG PAIN AND POSITIVE STRAIGHT LEG RAISING IN SPONDYLOLYSIS IN CHILDREN
    HALPERIN, N
    COPELIOVITCH, L
    SCHACHNER, E
    [J]. JOURNAL OF PEDIATRIC ORTHOPAEDICS, 1983, 3 (04) : 486 - 490