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Acute disc herniation following surgical decompression of lumbar spinal stenosis: a retrospective comparison of mini-open and minimally invasive techniques – Lumbar Spinal Stenosis

The article investigates the incidence of disc herniation as a complication of lumbar spinal stenosis surgery. The study compares two surgical techniques: mini-open bilateral partial laminectomy and minimally invasive laminotomy utilizing a tubular system. The results show that the postoperative disc herniation rate was significantly lower in the minimally invasive group compared to the mini-open group, with rates of 0.8% and 5.8%, respectively. This difference was even more pronounced in multi-level procedures. The findings emphasize the higher risk of postoperative disc herniation associated with the more extensive nature of mini-open surgery and relative segmental instability

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best recognised spinal hospital in London

Published article

CONCLUSION: The incidence of postoperative disc herniation following spinal decompression for symptomatic lumbar stenosis was 5.8% following mini-open bilateral partial laminectomy compared to only 0.8% after minimally invasive laminotomy (p = 0.002). These findings highlight the more extensive nature of mini-open surgery associated with relative segmental instability that poses a greater risk for postoperative disc herniation.

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J Orthop Surg Res. 2023 Dec 18;18(1):974. doi: 10.1186/s13018-023-04457-2.ABSTRACTBACKGROUND: Disc herniation following decompression of lumbar spinal stenosis is a less familiar surgical complication. Previous studies suggested that open lumbar decompression techniques, associated with relative segmental instability especially in the presence of degenerated disc in older patients, are more likely to result in disc herniation compared,

J Orthop Surg Res. 2023 Dec 18;18(1):974. doi: 10.1186/s13018-023-04457-2.

ABSTRACT

BACKGROUND: Disc herniation following decompression of lumbar spinal stenosis is a less familiar surgical complication. Previous studies suggested that open lumbar decompression techniques, associated with relative segmental instability especially in the presence of degenerated disc in older patients, are more likely to result in disc herniation compared to minimally invasive techniques. The current study compares the incidence of acute disc herniation following mini-open and minimally invasive decompression of lumbar spinal stenosis.

METHODS: This was a retrospective study reviewing 563 patients who underwent spinal decompression for symptomatic lumbar stenosis by mini-open bilateral partial laminectomy technique or minimally invasive laminotomy utilizing a tubular system. Demographic and clinical data were collected and compared between the groups.

RESULTS: Postoperative disc herniation rate was significantly lower in the minimally invasive group with 2 of 237 cases (0.8%) versus 19 of 326 cases (5.8%) in the mini-open group (p = 0.002). This finding was more noticeable following multi-level procedures with no case of postdecompression disc herniation in the minimally invasive group compared to 8 of 39 cases (20.5%) in the mini-open group (p = 0.003).

CONCLUSION: The incidence of postoperative disc herniation following spinal decompression for symptomatic lumbar stenosis was 5.8% following mini-open bilateral partial laminectomy compared to only 0.8% after minimally invasive laminotomy (p = 0.002). These findings highlight the more extensive nature of mini-open surgery associated with relative segmental instability that poses a greater risk for postoperative disc herniation.

PMID:38111077 | DOI:10.1186/s13018-023-04457-2

The London Spine Unit : best recognised spinal hospital in London

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Acute disc herniation following surgical decompression of lumbar spinal stenosis: a retrospective comparison of mini-open and minimally invasive techniques

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J Orthop Surg Res. 2023 Dec 18;18(1):974. doi: 10.1186/s13018-023-04457-2.ABSTRACTBACKGROUND: Disc herniation following decompression of lumbar spinal stenosis is a less familiar surgical complication. Previous studies suggested that open lumbar decompression techniques, associated with relative segmental instability especially in the presence of degenerated disc in older patients, are more likely to result in disc herniation compared

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