Mishra Sandeep, Garg Kanwaljeet, Chaurasia Bipin, Budihal Bhargavi R, Deora Harsh, Tandon Vivek, Phalak Manoj, Mishra Shashwat, Kumar Amandeep, Umana G E, Lafuente Jesus, Demetriades Andreas K, Ha Yoon, Singh Manmohan, Chandra P S, Kale S S, Zileli Mehmet
Department of Neurosurgery, Lok Nayak Hospital, New Delhi, India.
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
J Craniovertebr Junction Spine. 2023 Jul-Sep;14(3):259-267. doi: 10.4103/jcvjs.jcvjs_46_23. Epub 2023 Sep 18.
Lumbar discectomy is performed for symptomatic lumbar disc herniation and is one of the most widely performed spinal surgical procedures worldwide in a variety of ways. This survey aimed at providing an overview/perspective of different practice patterns and the impact of lumbar discectomy on axial back pain with or without sciatica.
An online survey was performed using the application "Google Forms." The link to the questionnaire was distributed to neurosurgeons through personal E-mail and social media platforms.
We received 333 responses. The largest percentage of responses across five continents was from Asia (66.97%, n = 223). The mean age of the respondents was 40.08 ± 10.5 years. A total of 66 respondents (20%) had a spine practice of 7%-90%, and 28 respondents had a spine practice of 90%-100% (8.4%). The number of respondents who practiced microscopic discectomy using a tubular retractor ( = 143 respondents, 42.9%) was nearly equal to the number of respondents who practiced open discectomy ( = 142 respondents, 42.6%). An almost equal proportion of respondents believed discectomy does not help in relieving axial back pain. Only 20.4% ( = 68) of respondents recommend bed rest for a longer duration postoperatively.
Our survey revealed that only 22.2% of spine surgeons recommended discectomy in patients with radiological disc herniation with axial back pain alone and preferred a minimally invasive method of discectomy. Almost half of them believed discectomy to be ineffective for axial low back pain and only a few recommended prolonged bed rest postoperatively.
腰椎间盘切除术用于治疗有症状的腰椎间盘突出症，是全球范围内以多种方式广泛开展的脊柱外科手术之一。本调查旨在概述/透视不同的手术方式以及腰椎间盘切除术对伴或不伴坐骨神经痛的下腰部轴向疼痛的影响。
使用“谷歌表单”应用程序进行在线调查。调查问卷的链接通过个人电子邮件和社交媒体平台分发给神经外科医生。
我们收到了333份回复。五大洲回复比例最高的是亚洲（66.97%，n = 223）。受访者的平均年龄为40.08±10.5岁。共有66名受访者（20%）的脊柱手术量占比为7% - 90%，28名受访者的脊柱手术量占比为90% - 100%（8.4%）。采用管状牵开器进行显微椎间盘切除术的受访者数量（143名受访者，42.9%）几乎与采用开放椎间盘切除术的受访者数量（142名受访者，42.6%）相等。几乎相同比例的受访者认为椎间盘切除术无助于缓解下腰部轴向疼痛。只有20.4%（n = 68）的受访者建议术后长时间卧床休息。
我们的调查显示，只有22.2%的脊柱外科医生建议对仅伴有下腰部轴向疼痛的影像学椎间盘突出症患者进行椎间盘切除术，并且更倾向于采用微创椎间盘切除方法。其中几乎一半的人认为椎间盘切除术对下腰部轴向疼痛无效，只有少数人建议术后长时间卧床休息。
