Characteristics and Short-Term Surgical Outcomes of Patients with Recurrent Lumbar Disc Herniation after Percutaneous Laser Disc Decompression

<i>Background and Objectives</i>: Although percutaneous laser disc decompression (PLDD) is one of the common treatment methods for patients with lumbar disc herniation (LDH), the recurrence of LDH after PLDD is estimated at 4–5%. This study compares the preoperative clinical data and cli...

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Autores principales:	Hidetomi Terai, Koji Tamai, Masayoshi Iwamae, Kunikazu Kaneda, Hiroshi Katsuda, Nagakazu Shimada, Hiroaki Nakamura
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	recurrence lumbar disc herniation percutaneous laser disc decompression microendoscopic decompression outcomes Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/526558d16c7941089220e624e1ec284a
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spelling	oai:doaj.org-article:526558d16c7941089220e624e1ec284a2021-11-25T18:18:45ZCharacteristics and Short-Term Surgical Outcomes of Patients with Recurrent Lumbar Disc Herniation after Percutaneous Laser Disc Decompression10.3390/medicina571112251648-91441010-660Xhttps://doaj.org/article/526558d16c7941089220e624e1ec284a2021-11-01T00:00:00Zhttps://www.mdpi.com/1648-9144/57/11/1225https://doaj.org/toc/1010-660Xhttps://doaj.org/toc/1648-9144<i>Background and Objectives</i>: Although percutaneous laser disc decompression (PLDD) is one of the common treatment methods for patients with lumbar disc herniation (LDH), the recurrence of LDH after PLDD is estimated at 4–5%. This study compares the preoperative clinical data and clinical outcomes of patients who underwent primary microendoscopic discectomy (MED) or MED following PLDD. <i>Materials and Methods</i>: We retrospectively analyzed 2678 patients who underwent MED for LDH. The PLDD group included patients with previous PLDD history at the same level of LDH, and a matched control group was created using propensity score matching for age, sex, and body mass index. Preoperative data, preoperative radiographic findings, and surgical data of the groups were compared. To compare postoperative changes in clinical scores between the groups, a mixed-effect model was used. <i>Results</i>: As a result, 42 patients (1.6%) had previously undergone PLDD, and a control group with 42 patients were created. The disc degeneration severity was not significantly different between the groups. However, Modic changes were more frequent in the PLDD group than in the matched control group (<i>p</i> = 0.028). There were no significant differences in dural adhesion rate or surgery-related complications including dural injury, length of stay, and recurrence rate of LDH after surgery. In addition, the improvement of clinical scores did not significantly differ between the two groups (<i>p</i> = 0.112, 0.913, respectively). <i>Conclusions</i>: We concluded that patients with recurrent LDH after PLDD have advanced endplate degeneration, which may reflect endplate injury from a previous PLDD. However, a previous history of PLDD does not have a negative impact on the clinical result of MED.Hidetomi TeraiKoji TamaiMasayoshi IwamaeKunikazu KanedaHiroshi KatsudaNagakazu ShimadaHiroaki NakamuraMDPI AGarticlerecurrencelumbar disc herniationpercutaneous laser disc decompressionmicroendoscopic decompressionoutcomesMedicine (General)R5-920ENMedicina, Vol 57, Iss 1225, p 1225 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	recurrence lumbar disc herniation percutaneous laser disc decompression microendoscopic decompression outcomes Medicine (General) R5-920
spellingShingle	recurrence lumbar disc herniation percutaneous laser disc decompression microendoscopic decompression outcomes Medicine (General) R5-920 Hidetomi Terai Koji Tamai Masayoshi Iwamae Kunikazu Kaneda Hiroshi Katsuda Nagakazu Shimada Hiroaki Nakamura Characteristics and Short-Term Surgical Outcomes of Patients with Recurrent Lumbar Disc Herniation after Percutaneous Laser Disc Decompression
description	<i>Background and Objectives</i>: Although percutaneous laser disc decompression (PLDD) is one of the common treatment methods for patients with lumbar disc herniation (LDH), the recurrence of LDH after PLDD is estimated at 4–5%. This study compares the preoperative clinical data and clinical outcomes of patients who underwent primary microendoscopic discectomy (MED) or MED following PLDD. <i>Materials and Methods</i>: We retrospectively analyzed 2678 patients who underwent MED for LDH. The PLDD group included patients with previous PLDD history at the same level of LDH, and a matched control group was created using propensity score matching for age, sex, and body mass index. Preoperative data, preoperative radiographic findings, and surgical data of the groups were compared. To compare postoperative changes in clinical scores between the groups, a mixed-effect model was used. <i>Results</i>: As a result, 42 patients (1.6%) had previously undergone PLDD, and a control group with 42 patients were created. The disc degeneration severity was not significantly different between the groups. However, Modic changes were more frequent in the PLDD group than in the matched control group (<i>p</i> = 0.028). There were no significant differences in dural adhesion rate or surgery-related complications including dural injury, length of stay, and recurrence rate of LDH after surgery. In addition, the improvement of clinical scores did not significantly differ between the two groups (<i>p</i> = 0.112, 0.913, respectively). <i>Conclusions</i>: We concluded that patients with recurrent LDH after PLDD have advanced endplate degeneration, which may reflect endplate injury from a previous PLDD. However, a previous history of PLDD does not have a negative impact on the clinical result of MED.
format	article
author	Hidetomi Terai Koji Tamai Masayoshi Iwamae Kunikazu Kaneda Hiroshi Katsuda Nagakazu Shimada Hiroaki Nakamura
author_facet	Hidetomi Terai Koji Tamai Masayoshi Iwamae Kunikazu Kaneda Hiroshi Katsuda Nagakazu Shimada Hiroaki Nakamura
author_sort	Hidetomi Terai
title	Characteristics and Short-Term Surgical Outcomes of Patients with Recurrent Lumbar Disc Herniation after Percutaneous Laser Disc Decompression
title_short	Characteristics and Short-Term Surgical Outcomes of Patients with Recurrent Lumbar Disc Herniation after Percutaneous Laser Disc Decompression
title_full	Characteristics and Short-Term Surgical Outcomes of Patients with Recurrent Lumbar Disc Herniation after Percutaneous Laser Disc Decompression
title_fullStr	Characteristics and Short-Term Surgical Outcomes of Patients with Recurrent Lumbar Disc Herniation after Percutaneous Laser Disc Decompression
title_full_unstemmed	Characteristics and Short-Term Surgical Outcomes of Patients with Recurrent Lumbar Disc Herniation after Percutaneous Laser Disc Decompression
title_sort	characteristics and short-term surgical outcomes of patients with recurrent lumbar disc herniation after percutaneous laser disc decompression
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/526558d16c7941089220e624e1ec284a
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Characteristics and Short-Term Surgical Outcomes of Patients with Recurrent Lumbar Disc Herniation after Percutaneous Laser Disc Decompression

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