Volume 1, Issue 1 (6-2015)                   Iran J Neurosurg 2015, 1(1): 23-27 | Back to browse issues page


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Azimi P, Mohammadi H, Nayeb-Aghaei H, Azhari S, Safdari-Ghandehari H, Sadeghi S. Functionality Status and Surgical Outcome of Fenestration versus Laminotomy Discectomy in Patients with Lumbar Disc Herniation. Iran J Neurosurg 2015; 1 (1) :23-27
URL: http://irjns.org/article-1-2-en.html
Abstract:   (5890 Views)

Background & Aim: To assess functionality status and surgical outcome of fenestration versus laminotomy technique based on Core Outcome Measures Index (COMI) in patients with lumbar disc hernia (LDH).

Methods & Materials/Patients: A cross-sectional study was performed between January 2007 and April 2012. A total of 108 patients with a single-level disc herniation were asked to respond to the Oswestry Disabiltiy Index (ODI) and COMI at two points in time: pre- and post-operative assessments. The ODI and COMI were assessed comparing patients’ pre- and postoperative scores to determine the functionality status and surgical outcome.

Results: The mean age of patients was 52.4 (SD=10.1) years who underwent fenestration (n=45) or laminotomy discectomy (n=63). The mean clinical follow-up was 27.8 (SD=3.6) months (range 24 - 37 months). Regarding COMI scores, all subgroup values showed statistical significance pre- and postoperative indicating improvements on the outcomes and functionality. The change in the ODI after surgery was strongly correlated with change in the COMI, (r=0.79; P<0.001). The ODI score also was found to be statistically different between the groups in pre-and postoperative (P<0.001) assessment. However, the functionality status rate was similar in both groups.

Conclusion: The findings suggest that fenestration or laminotomy discectomy is an efficacious procedure for treatment of LDH. However, both methods are equally effective in surgical outcome.

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Type of Study: Research | Subject: Gamma Knife Radiosurgery

References
1. Kordi R, Rostami M. Low back pain in children and adolescents: an algorithmic clinical approach. Iran J Pediatr. 2011;21(3):259-70. [PMID] [PMCID]
2. Li Y, Fredrickson V, Resnick DK. How Should We Grade Lumbar Disc Herniation and Nerve Root Compression? A Systematic Review. Clin Orthop Relat Res. 2014 May 14. [Epub ahead of print]
3. Fardon DF, Milette PC. Nomenclature and classification of lumbar disc pathology: recommendations of the Combined Task Forces of the North American Spine Society, American Society of Spine Radiology, and American Society of Neuroradiology. Spine. 2001;26(5):E93-E113. [DOI:10.1097/00007632-200103010-00006] [PMID]
4. Deyo RA, Battie M, Beurskens AJ, et al. Outcome measures for low back pain research. A proposal for standardized use. Spine. 1998;23(18):2003-13. [DOI:10.1097/00007632-199809150-00018] [PMID]
5. Mohammadi HR, Azimi P, Zali AR, et al. An outcome measure of functionality and pain in patients with low back disorder: a validation study of the Iranian version of Core Outcome Measures Index (COMI). Asian J Neurosurg 2014 [Epub ahead of print].
6. Padua R, Padua S. Romanini E. Ten to 15 year outcome of surgery for lumbar disc hemiations: radiographic instability and clinical fndings. Eur Spine J. 1999;8(1):70-4. [DOI:10.1007/s005860050129] [PMID] [PMCID]
7. Garg B, Nagraja UB, Jayaswal A. Microendoscopic versus open discectomy for lumbar disc herniation: a prospective randomised study. J Orthop Surg (Hong Kong). 2011;19(1):30-4. [DOI:10.1177/230949901101900107] [PMID]
8. Akbar A, Mahar A. Lumbar disc prolapse: management and outcome analysis of 96 surgically treated patients. J Pak Med Assoc. 2002;52(2):62-5. [PMID]
9. Mannion AF, Porchet F, Kleinstück FS, et al. The quality of spine surgery from the patient's perspective. Part 1: the Core Outcome Measures Index in clinical practice. Eur Spine J. 2009;18 Suppl 3:367-73. https://doi.org/10.1007/s00586-009-0931-y [DOI:10.1007/s00586-009-0942-8]
10. Mousavi SJ, Parnianpour M, Mehdian H, et al. The Oswestry Disability Index, the Roland-Morris Disability Questionnaire, and the Quebec Back Pain Disability Scale: translation and validation studies of the Iranian versions. Spine. 2006;31(14):E454-9. [DOI:10.1097/01.brs.0000222141.61424.f7] [PMID]
11. Kahanovitz N, Viola K, McCulloch J. Limited surgical discectomy and microdiscectomy. A clinical comparison. Spine. 1989;14(1):79-81. [DOI:10.1097/00007632-198901000-00016] [PMID]
12. Spengler DM. Lumbar discectomy. Results with limited disc excision and selective foraminotomy. Spine. 1982;7(6):604-7. [DOI:10.1097/00007632-198211000-00015]
13. Mayer HM, Brock M. Percutaneous endoscopic discectomy: surgical technique and preliminary results compared to microsurgical discectomy. J Neurosurg. 1993;78(2):216-25. [DOI:10.3171/jns.1993.78.2.0216] [PMID]
14. Stolke D, Sollmann WP, Seifert V. Intra- and postoperative complications in lumbar disc surgery. Spine. 1989;14(1):56-9. [DOI:10.1097/00007632-198901000-00011] [PMID]
15. Lew SM, Mehalic TF, Fagone KL. Transforaminal percutaneous endoscopic discectomy in the treatment of far-lateral and foraminal lumbar disc herniations. J Neurosurg. 2001;94 (2 Suppl):216-20. [PMID]
16. WHO: Process of translation and adaptation of instruments. [Available from http://www.who.int/substance_abuse/research_tools/translation/en/]
17. Tabatabaei SM, Seddighi AS, Seddighi A, et al. Clinical Results of 30 Years Surgery On 2026 Patients with Lumbar Disc Herniation. WScJ. 2012;3: 80-86.
18. Lakicević G1, Ostojić L, Splavski B, et al. Comparative outcome analyses of differently surgical approaches to lumbar disc herniation. Coll Antropol. 2009;33 Suppl 2:79-84. [PMID]
19. Grøvle L, Haugen AJ, Keller A, Natvig B, Brox JI, Grotle M. Reliability, validity, and responsiveness of the Norwegian versions of the Maine-Seattle Back Questionnaire and the Sciatica Bothersomeness and Frequency Indices. Spine . 2008;33(21):2347-53. [DOI:10.1097/BRS.0b013e31818047d6] [PMID]

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