Abstract
The objective of this case is to provide an update based on the current highest level of evidence on several aspects of one the most commonly performed neurosurgical procedures, lumbar disc surgery for sciatica. Using a straightforward case we discuss the following issues: timing of surgery for sciatica, surgical approach of symptomatic disk herniation surgery (tube, transforaminal or microdiscektomy), and technique of removal (nucleo- and sequesterectomy).
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Peul WC, van Houwelingen HC, van den Hout WB, Brand R, Eekhof JA, Tans JT, Thomeer RT, Koes BW. Surgery versus prolonged conservative treatment for sciatica. N Engl J Med. 2007;356(22):2245–56.
Lequin MB, Verbaan D, Jacobs WC, Brand R, Bouma GJ, Vandertop WP, Peul WC, Leiden-The Hague Spine Intervention Prognostic Study Group, Peul WC, Koes BW, Thomeer RTWM, van den Hout WB, Brand R. Surgery versus prolonged conservative treatment for sciatica: 5-year results of a randomised controlled trial. BMJ Open. 2013;3(5):e002534.
Overdevest GM, Vleggeert-Lankamp CL, Jacobs WC, Brand R, Koes BW, Peul WC. Recovery of motor deficit accompanying sciatica--subgroup analysis of a randomized controlled trial. Spine J. 2014;14(9):1817–24. https://doi.org/10.1016/j.spinee.2013.07.456. Epub 2013 Nov 5.
Petr O, Glodny B, Brawanski K, Kerschbaumer J, Freyschlag C, Pinggera D, Rehwald R, Hartmann S, Ortler M, Thomé C. Immediate versus delayed surgical treatment of lumbar disc herniation for acute motor deficits: the impact of surgical timing on functional outcome. Spine (Phila Pa 1976). 2017. (Publish ahead of print)
EL Barzouhi A, Vleggeert-Lankamp CL, Lycklama À Nijeholt GJ, Van der Kallen BF, van den Hout WB, Verwoerd AJ, Koes BW, Peul WC. Magnetic resonance imaging interpretation in patients with sciatica who are potential candidates for lumbar disc surgery. Paul F, editor. PLoS One 2013;8(7):e68411–11.
Arts MP, Brand R, van den Akker ME, Koes BW, Bartels RH, Peul WC. Tubular diskectomy vs conventional microdiskectomy for sciatica: a randomized controlled trial. JAMA. 2009;302(2):149–58.
Kamper SJ, Ostelo RW, Rubinstein SM, Nellensteijn JM, Peul WC, Arts MP, van Tulder MW. Minimally invasive surgery for lumbar disc herniation: a systematic review and meta-analysis. Eur Spine J. 2014;23(5):1021–43.
Azarhomayoun A, Chou R, Shirdel S, Lakeh MM, Vaccaro AR, Rahimi-Movaghar V. Sequestrectomy versus conventional microdiscectomy for the treatment of a lumbar disc herniation: a systematic review. Spine (Phila Pa 1976). 2015;40(24):E1330–9.
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van der Gaag, N.A., Moojen, W.A. (2019). Lumbar Disc Herniation, Nucleo- and Sequesterectomy. In: Meyer, B., Rauschmann, M. (eds) Spine Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-98875-7_9
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DOI: https://doi.org/10.1007/978-3-319-98875-7_9
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