Surgery for leg and back pain caused by damage to spinal discs

What is it about?

Background When the discs between vertebrae in the spine become damaged (herniated), the soft gel inside them pushes through the wall of the disc and presses against the nerves or the spinal cord, causing a burning pain in legs and pain in the back. When this happens in the lower back, it i s known as lumbar disc herniation. Review question The main treatment for this condition is lumbar discectomy, which involves removing the part of the disc pressing on the nerves. There are two main types of this surgery. The first type is standard microdiscectomy, which can be performed with the aid of microscope magnification or headlight loupe, or open discectomy where surgeons do not use a microscope or loupe (MD/OD). However, all steps of the operations are similar. The second type of operation is minimally invasive discectomy (MID) procedures. MID involves a smaller incision and less damage to the surrounding tissue. We reviewed the evidence to see if one type of surgery is more effective than the other type of surgery in terms of the results after surgery including pain in the legs, low back pain, problems with mobility or numbness and disability. Study characteristics We found 11 studies up to November 2013, examining 1172 people, with studies ranging from 22 to 325 participants, and people aged from 12 to 70 years. All had tried non-surgical treatments and all had leg pain that was worse than their back pain. The followup period after surgery ranged from five days to 56 months. People who had a MD/OD had less pain in their legs, and less low back pain, but the difference was small. They were less likely to need a second operation because the first had been unsuccessful. They felt slightly better in some physical aspects of their quality of life, but again the difference was too small to be meaningful. In terms of complications, the two operations were similar, though people who had a MD/OD were more likely to have wound infections.

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Why is it important?

Comparison between two popular methods of surgical treatment of disc

Perspectives