Minimally invasive discectomy versus open laminectomy and discectomy for the treatment of cauda equina syndrome: A preliminary study and case series.
case series
cauda equina syndrome
minimally invasive
open laminectomy
tubular discectomy
Journal
Frontiers in surgery
ISSN: 2296-875X
Titre abrégé: Front Surg
Pays: Switzerland
ID NLM: 101645127
Informations de publication
Date de publication:
2022
2022
Historique:
received:
30
08
2022
accepted:
27
09
2022
entrez:
31
10
2022
pubmed:
1
11
2022
medline:
1
11
2022
Statut:
epublish
Résumé
Cauda Equina syndrome (CES) is a potentially devastating condition and is treated usually with urgent open surgical decompression of the spinal canal. Currently, the role of minimally invasive discectomy (MID) as an alternative surgical technique for CES is unclear. The purpose of this study was to compare clinical outcomes following MID and open laminectomy and discectomy for the treatment of CES. The study cohort included patients that underwent surgery due to CES at our institute. Patients' outcomes included: surgical complications, length of hospitalization, postoperative lower extremity motor score (LEMS), Numerical Rating Scale (NRS) for leg and back pain, Oswestry disability index (ODI), and the EQ-5D health-related quality of life questionnaire. Twelve patients underwent MID and 12 underwent open laminectomy and discectomy. Complications and revisions rates were comparable between the groups. Postoperative urine incontinence and saddle dysesthesia improved in 50% of patients in both groups. LEMS improved from 47.08 ± 5.4 to 49.27 ± 0.9 in the MID group and from 44.46 ± 5.9 to 49.0 ± 1.4 in the open group. Although, leg pain improved in both groups from 8.4 ± 2.4 to 3 ± 2.1 in the MID and from 8.44 ± 3.3 to 3.88 ± 3 in the open group, significant improvement in back pain was found only in the MID group. Final functional scores were similar between groups. Our preliminary results suggest that minimally invasive discectomy is an effective and safe procedure for the treatment of CES when compared to open laminectomy and discectomy. However, MID in these cases should only be considered by surgeons experienced in minimally invasive spine surgery. Further studies with bigger sample sizes and long-term follow-ups are needed.
Sections du résumé
Background
UNASSIGNED
Cauda Equina syndrome (CES) is a potentially devastating condition and is treated usually with urgent open surgical decompression of the spinal canal. Currently, the role of minimally invasive discectomy (MID) as an alternative surgical technique for CES is unclear.
Objective
UNASSIGNED
The purpose of this study was to compare clinical outcomes following MID and open laminectomy and discectomy for the treatment of CES.
Methods
UNASSIGNED
The study cohort included patients that underwent surgery due to CES at our institute. Patients' outcomes included: surgical complications, length of hospitalization, postoperative lower extremity motor score (LEMS), Numerical Rating Scale (NRS) for leg and back pain, Oswestry disability index (ODI), and the EQ-5D health-related quality of life questionnaire.
Results
UNASSIGNED
Twelve patients underwent MID and 12 underwent open laminectomy and discectomy. Complications and revisions rates were comparable between the groups. Postoperative urine incontinence and saddle dysesthesia improved in 50% of patients in both groups. LEMS improved from 47.08 ± 5.4 to 49.27 ± 0.9 in the MID group and from 44.46 ± 5.9 to 49.0 ± 1.4 in the open group. Although, leg pain improved in both groups from 8.4 ± 2.4 to 3 ± 2.1 in the MID and from 8.44 ± 3.3 to 3.88 ± 3 in the open group, significant improvement in back pain was found only in the MID group. Final functional scores were similar between groups.
Conclusions
UNASSIGNED
Our preliminary results suggest that minimally invasive discectomy is an effective and safe procedure for the treatment of CES when compared to open laminectomy and discectomy. However, MID in these cases should only be considered by surgeons experienced in minimally invasive spine surgery. Further studies with bigger sample sizes and long-term follow-ups are needed.
Identifiants
pubmed: 36311945
doi: 10.3389/fsurg.2022.1031919
pmc: PMC9597079
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1031919Informations de copyright
© 2022 Khashan, Ofir, Grundshtein, Kuzmenko, Salame, Niry, Hochberg, Lidar and Regev.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Turk J Phys Med Rehabil. 2019 Feb 01;65(3):222-227
pubmed: 31663070
Acta Neurochir (Wien). 2019 Sep;161(9):1887-1894
pubmed: 31263950
Clin Orthop Relat Res. 2014 Jun;472(6):1711-7
pubmed: 24510358
Acta Neurol Belg. 2016 Jun;116(2):185-90
pubmed: 26292929
J Neurosurg Spine. 2009 Oct;11(4):471-6
pubmed: 19929344
Eur Spine J. 2017 Mar;26(3):894-904
pubmed: 28102451
J Neurosurg Spine. 2014 Aug;21(2):179-86
pubmed: 24878273
Neurosurg Focus. 1999 Nov 15;7(5):e5
pubmed: 16918212
Spine (Phila Pa 1976). 2000 Jun 15;25(12):1515-22
pubmed: 10851100
J Clin Neurosci. 2011 Sep;18(9):1219-23
pubmed: 21752648
Br J Neurosurg. 2002 Aug;16(4):325-8
pubmed: 12389883
Spine (Phila Pa 1976). 2018 Sep 1;43(17):E1005-E1013
pubmed: 29432394
J Bone Joint Surg Am. 1986 Mar;68(3):386-91
pubmed: 2936744
J Racial Ethn Health Disparities. 2018 Apr;5(2):287-292
pubmed: 28434102
Spine (Phila Pa 1976). 2007 Jan 15;32(2):207-16
pubmed: 17224816
Rev Bras Ortop. 2017 Dec 06;53(1):107-112
pubmed: 29367915
Minim Invasive Neurosurg. 2008 Apr;51(2):100-5
pubmed: 18401823
J Neurosurg Spine. 2011 Jun;14(6):771-8
pubmed: 21417699
Spine J. 2017 Oct;17(10):1435-1448
pubmed: 28456676
Neurosurg Focus. 2017 Aug;43(2):E7
pubmed: 28760036
J Neurosurg Spine. 2020 Feb 14;:1-10
pubmed: 32059184
J Med Invest. 2015;62(1-2):100-2
pubmed: 25817294
Neurosurgery. 2002 Nov;51(5 Suppl):S146-54
pubmed: 12234442
Acta Orthop. 2010 Jun;81(3):391-5
pubmed: 20443745
J Spinal Disord Tech. 2009 May;22(3):202-6
pubmed: 19412023
Arch Phys Med Rehabil. 1994 Jul;75(7):756-60
pubmed: 8024420