No abstract available.
Diskectomy*

Operative methods are changing from aggressive open methods to less invasive methods including microscopic discectomy and various kinds of percutaneous methods. In spite of having definite advantages, percutaneous methods still have limited indications and no uniformly convincing clinical results. Microscopic discectomy has advantages of those of open methods and percutaneous methods. A review of clinical results of operative treatment for lumbar disc herniation shows favorable long-term results. For the better long-term results, we should understand the proper indications of each treatment modalities.
Diskectomy

No abstract available.
Diskectomy*

Thepercutaneous treatmentof lumbardisc diseasewithlaser energyhas recently emerged as an alternative to standard open surgery or mechanical percutaneous methods. The indications of percutaneousendoscopic laser discectomy should, however, be well evaluated according to clinical and morphological criteria. We report three cases of herniated lumbar disc treated with conventional open surgery after the failure of laser discectomy.
Diskectomy*

No abstract available.
Diskectomy*

No abstract available.
Diskectomy*

No abstract available.
Diskectomy*

OBJECTIVES: The purposes of this study were to 1) develope web-based information program for the patients undergoing lumbar discectomy, and 2) test the effectiveness of web-based information program for improving patients knowledge level on lumbar discectomy. METHODS: First, to improve the validity of contents of web-based program, the information needs were identified from 30 patients admitted for lumbar discectomy and experts' validation of preliminary contents of program was performed. Second, satisfaction level of the developed program was measured by 15 experts and 20 patients. Finally, the outcome of web-based program was compared by each of 20 lumbar discectomy patients allocated to experimental group (EG) and control group(CG) in term of knowledge level. RESULTS: The web-based program was developed with 24 screens categorized 6 categories. Satisfaction scores on information relevance and information usefulness of experts were higher than those of patients. The EG's scores on knowledge level was significantly higher than those of CG. CONCLUSIONS: We can conclude that web-based information program is more effective tool than the traditional education method to enhancing knowledge level. We suggest that various web-based programs for other patient groups expecting surgeries should be developed in order to satisfy the patients' needs more effectively.
Diskectomy ; Humans

OBJECTIVE: The purpose of this study was to evaluate the efficacy of a transforaminal suprapedicular approach, semi-rigid flexible curved probe, and 3-dimensional reconstruction computed tomography (3D-CT) with discogram in the endoscopic treatment of non-contained lumbar disc herniations. METHODS: The subjects were 153 patients with difficult, non-contained lumbar disc herniations undergoing endoscopic treatment. The types of herniation were as follows : extraforaminal, 17 patients; foraminal, 21 patients; high grade migration, 59 patients; and high canal compromise, 56 patients. To overcome the difficulties in endoscopic treatment, the anatomic structures were analyzed by 3D reconstruction CT and the high grade disc was extracted using a semi-rigid flexible curved probe and a transforaminal suprapedicular approach. RESULTS: The mean follow-up was 18.3 months. The mean visual analogue scale (VAS) of the patients prior to surgery was 9.48, and the mean postoperative VAS was 1.63. According to Macnab's criteria, 145 patients had excellent and good results, and thus satisfactory results were obtained in 94.77% cases. CONCLUSION: In a posterolateral endoscopic lumbar discectomy, the difficult, non-contained disc is considered to be the most important factor impeding the success of surgery. By applying a semi-rigid flexible curved probe and using a transforaminal suprapedicular approach, good surgical results can be obtained, even in high grade, non-contained disc herniations.
Diskectomy ; Diskectomy, Percutaneous ; Follow-Up Studies ; Humans

STUDY DESIGN: Randomized controlled trial. PURPOSE: We compared the disability and functional outcome after conservative treatment with prolonged physiotherapy versus early surgical intervention in patients with lumbar disk herniation. OVERVIEW OF LITERATURE: Lumbar disk herniation is one of the most common causes of job-related disability in individuals less than 45 years old. Conservative treatment is the initial pathway for the majority of patients but the duration of conservative treatment remains debatable and the adverse effects of prolonged conservative treatment are still unclear. Prolonged duration of symptoms before surgical intervention is associated with worse outcomes than a short period of symptoms. METHODS: From June 2011 to July 2013, 60 patients with lumbar disk herniation at our institute were randomized into two groups. Group I was treated with prolonged physiotherapy and rehabilitation for 6 months, while group II was treated with early surgical discectomy. Oswestry disability index was used to assess disability, while the Prolo economic outcome rating scale was used to assess the work status. RESULTS: Most patients were males between 21 and 45 years old (mean age, 35.88±7.15). There was significant improvement in the disability and work status in both groups without statistically significant differences in the disability score at the second or third assessment. However, the Prolo scale became significantly better in group I than in group II patients during the second and third assessments. CONCLUSIONS: A prolonged physiotherapy and rehabilitation program is a beneficial and successful treatment in patients with recently diagnosed lumbar disk herniation.
Diskectomy ; Humans ; Male ; Rehabilitation