Resultaten hernia chirurgie literatuur

Resultaten internationale literatuur microscopisch en endoscopisch herniaverwijdering.

SPORT trial laat betere resultaten zien bij chirurgische interventie in vergelijking met conservatieve zorg in de behandeling van discus herniatie.

European Musculoskeletal Review 2007 ( publicatie van de resultaten van het naonderzoek Rugkliniek)

Transforaminal Endoscopic Surgery

Technique and Provisional Results in Primary Disc Herniation. M. Iprenburg, Spine Clinic Heerenveen, The Netherlands. Nederlands tijdschrift voor Geneeskunde; 2005 2 juli,149(27). Luijsterburg a.o.

  •  Incidence 5 by 1000 patients a year
  • NL. 60.000 - 70.000 x LRS a year
  • 1988 10.000 OR's due to LRS a year
  • NL 6 x Scotland
  • 4 x England
  • 2 x Sweden 

Nederlands Tijdschrift voor Geneeskunde; 2005 2 juli;149(27) Luijsterburg a.o.

  • 250 pat. Retrospective/prospective descriptive, 7 neurosurgeons 4 hospitals, HNP l4/L5 of HNP L5/S1 OK's due to LRS
  • 163 patients responded
  • 37% was 19 /12 postop. symptom free
  • 63% more or less still LRS complaints
  • 21 of 163 (13% ) patients were operated 2 x
  • 4 of 163 ( 2,5%) patients were operated 3 x
  • 87 % = > 5 satisfaction score ( scale 1 to 10)
  • Prognostic factors: female and age 51-65 are associated significantly with persisting LRS symptoms after operation 
  •  Lumbar disc herniation; Spine 1983;8:131-140 Weber H.
  • A controlled, prospective study with ten years of observation (effectiveness operation versus conservative treatment)
  • After 1 year 90% of the operated patients better, 60% conservative group better
  • After 4 year no significant difference
  • After 10 year results the same 

Nederlands Tijdschrift voor Geneeskunde 1989;133:2615-9 Habbema, Braakman a.o.

De condition of patients one year after operation due to LRS 35% still legpain. In literature many groups and many different methods

  • Large variation as result of different investigation methods
  • Success percentage operation in LRS varies widely from 40% to 90% 

One-year report from the Swedish National Spine Register. Acta Orthopaedica Suppl.319 Vol 76 October 2005. Lumbar disc herniation, One year follow up

  • 2796 Patients, 57% men, 43% women
  • Preop. mean back pain (VAS) 48 Postop. 27
  • Preop. mean leg pain (VAS) 66 Postop. 23
  • Consumption of analgesics one year postop.
  • Regular 17%, intermittent 33%, no consuption 50%.
  • Walking distance one year postop < 100 meter 4%, 100-500 m 9%, 500m-1km 16%, > 1 km 71%
  • Back pain as compared to preop.: painfree 24%, almost painfree 48%, somewhat improved 15%, unchanged 8% and deteriorated 4%
  • Legpain as compared to preop.: painfree 32%, almost painfree 42%, somewhat improved 18%, unchanged 5% and deteriorated 3%
  • Overall patient satisfaction with outcome of surgery:   
  • satisfied 76%   
  • irresolute 17%   
  • dissatisfied 7%