Acute disc herniation following surgical decompression of lumbar spinal stenosis: a retrospective comparison of mini-open and minimally invasive techniques
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...
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-023-04457-2 |
| _version_ | 1827399424405405696 |
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| author | Ofir Uri Liad Alfandari Yoram Folman Amit Keren William Smith Inbar Paz Eyal Behrbalk |
| author_facet | Ofir Uri Liad Alfandari Yoram Folman Amit Keren William Smith Inbar Paz Eyal Behrbalk |
| author_sort | Ofir Uri |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-08T19:45:48Z |
| format | Article |
| id | doaj.art-ccd20c5f1f964cabbe0406fae80927d6 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-03-08T19:45:48Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-ccd20c5f1f964cabbe0406fae80927d62023-12-24T12:24:34ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2023-12-011811710.1186/s13018-023-04457-2Acute disc herniation following surgical decompression of lumbar spinal stenosis: a retrospective comparison of mini-open and minimally invasive techniquesOfir Uri0Liad Alfandari1Yoram Folman2Amit Keren3William Smith4Inbar Paz5Eyal Behrbalk6Spine Surgery Unit, Orthopedic Department, Hillel Yaffe Medical CenterSpine Surgery Unit, Orthopedic Department, Hillel Yaffe Medical CenterSpine Surgery Unit, Orthopedic Department, Hillel Yaffe Medical CenterSpine Surgery Unit, Orthopedic Department, Hillel Yaffe Medical CenterDepartment of Neurosurgery, University Medical CenterSpine Surgery Unit, Orthopedic Department, Hillel Yaffe Medical CenterSpine Surgery Unit, Orthopedic Department, Hillel Yaffe Medical CenterAbstract 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.https://doi.org/10.1186/s13018-023-04457-2Lumbar spinal stenosisMinimally invasive spine decompressionMini-open spine decompressionPostoperative disc herniationLumbar instability |
| spellingShingle | Ofir Uri Liad Alfandari Yoram Folman Amit Keren William Smith Inbar Paz Eyal Behrbalk Acute disc herniation following surgical decompression of lumbar spinal stenosis: a retrospective comparison of mini-open and minimally invasive techniques Journal of Orthopaedic Surgery and Research Lumbar spinal stenosis Minimally invasive spine decompression Mini-open spine decompression Postoperative disc herniation Lumbar instability |
| title | Acute disc herniation following surgical decompression of lumbar spinal stenosis: a retrospective comparison of mini-open and minimally invasive techniques |
| title_full | Acute disc herniation following surgical decompression of lumbar spinal stenosis: a retrospective comparison of mini-open and minimally invasive techniques |
| title_fullStr | Acute disc herniation following surgical decompression of lumbar spinal stenosis: a retrospective comparison of mini-open and minimally invasive techniques |
| title_full_unstemmed | Acute disc herniation following surgical decompression of lumbar spinal stenosis: a retrospective comparison of mini-open and minimally invasive techniques |
| title_short | Acute disc herniation following surgical decompression of lumbar spinal stenosis: a retrospective comparison of mini-open and minimally invasive techniques |
| title_sort | acute disc herniation following surgical decompression of lumbar spinal stenosis a retrospective comparison of mini open and minimally invasive techniques |
| topic | Lumbar spinal stenosis Minimally invasive spine decompression Mini-open spine decompression Postoperative disc herniation Lumbar instability |
| url | https://doi.org/10.1186/s13018-023-04457-2 |
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