Literatur: Resultate, Hernienchirurgie

Resultaten internationale literatuur microscopische herniaverwijdering van dorsaal (Herniated Disc Surgery)

Nederlands tijdschrift voor Geneeskunde; 2005 2 juli,149(27)
Luijsterburg a.o.
 

  • Incidence 5 by 1000 patients per year
  • NL. 60,000 - 70,000 x LRS per year
  • 1988 10,000 OR's due to LRS per year
  • NL 6 x Scotland
  • 4 x England
  • 2 x Sweden


 

 

Dutch Journal of Medicine; 2005 2 July;149(27)
Luijsterburg et al
 

  • 250 pat. Retrospective/prospective descriptive, 7 neurosurgeons 4 hospitals, HNP l4/L5 of HNP L5/S1 OR's due to LRS
  • 163 patients responded
  • 37% was 19 /12 postop. symptom free
  • 63% more or less retained LRS symptoms
  • 21 of 163 (13% ) patients were operated 2 x
  • 4 of 163 ( 2.5%) patients were operated 3 x
  • 87 % = > 5 satisfaction score ( scale 1 to 10)
  • Prognostic factors: female and age 51-65 are associated significantly with persistent LRS symptoms after operation


 

 

Lumbar disc herniation; Spine 1983;8:131-140
Weber H.
 

  • A controlled, prospective study with ten years of observations (effectiveness operation versus conservative treatment)
  • After 1 year 90% of the operated patients better, 60% conservative group better
  • After 4 year no significant difference
  • After 10 year results the same


 

 

Dutch Journal of Medicine 1989;133:2615-9
Habbema, Braakman a.o.
The condition of patients one year after operation due to LRS: 35% contniued leg painThe condition of patients one year after operation due to LRS: 35% contniued leg pain

In literature many groups and many different methods

  • Large variation as result of different investigation methods
  • Success percentage operation in LRS varies widely from 40% to 90%

 

One-year report from the Swedish National Spine Register
Acta Orthopaedica Suppl. 319 Vol 76 October 2005
Lumbar disc herniation, one-year follow up

  • 2796 Patients, 57% male, 43% female
  • Preop. mean back pain (VAS) 48 Postop. 27
  • Preop. mean leg pain (VAS) 66 Postop. 23
  • Consumption of analgesics one year postop.
  • Regular 17%, intermittent 33%, no consuption 50%.
  • Walking distance one year postop < 100 meter 4%, 100-500 m 9%, 500m-1km 16%, > 1 km 71%
  • Back pain as compared to preop.: painfree 24%, almost painfree 48%, somewhat improved 15%, unchanged 8% and deteriorated 4%
  • Leg pain as compared to preop.: pain-free 32%, almost pain-free 42%, somewhat improved 18%, unchanged 5% and deteriorated 3%
  • Overall patient satisfaction with outcome of surgery:   
  • satisfied 76%   
  • irresolute 17%   
  • dissatisfied 7%