La Rocca Giuseppe, Galieri Gianluca, Mazzucchi Edoardo, Pignotti Fabrizio, Orlando Vittorio, Pappalardo Simona, Olivi Alessandro, Sabatino Giovanni
Institute of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, 00168 Rome, Italy.
Neurosurgical Training Center and Brain Research, Mater Olbia Hospital, 07026 Olbia, Italy.
J Clin Med. 2024 Jun 18;13(12):3571. doi: 10.3390/jcm13123571.
: Lumbar disc herniation, a complex challenge in spinal health, significantly impacts individuals across diverse age groups. This article delves into the intricacies of this condition, emphasising the pivotal role of anatomical considerations in its understanding and management. Additionally, lumbar discectomy might be considered an "easy" surgery; nevertheless, it carries significant risks. The aim of the study was to present a groundbreaking "three-step approach" with some anatomical insight derived from our comprehensive clinical experiences, designed to systematise the surgical approach and optimise the outcomes, especially for young spine surgeons. We highlighted the purpose of the study and introduced our research question(s) and the context surrounding them. : This retrospective study involved patients treated for lumbar disc herniation at a single institution. The patient demographics, surgical details, and postoperative assessments were meticulously recorded. All surgeries were performed by a consistent surgical team. : A total of 847 patients of the 998 patients initially included completed the follow-up period. A three-step approach was performed for every patient. The recurrence rate was 1.89%. Furthermore, the incidence of lumbar instability and the need for reoperation were carefully examined, presenting a holistic view of the outcomes. : The three-step approach emerged as a robust and effective strategy for addressing lumbar disc herniation. This structured approach ensures a safe and educational experience for young spinal surgeons.
腰椎间盘突出症是脊柱健康领域的一个复杂挑战,对不同年龄组的个体都有显著影响。本文深入探讨了这种病症的复杂性,强调了解剖学因素在其理解和治疗中的关键作用。此外,腰椎间盘切除术可能被认为是一种“简单”的手术;然而,它也存在重大风险。本研究的目的是提出一种开创性的“三步法”,该方法源于我们全面的临床经验,具有一定的解剖学见解,旨在使手术方法系统化并优化治疗效果,尤其是对年轻的脊柱外科医生而言。我们强调了研究的目的,并介绍了我们的研究问题及其背景。:这项回顾性研究涉及在单一机构接受腰椎间盘突出症治疗的患者。详细记录了患者的人口统计学数据、手术细节和术后评估情况。所有手术均由一个固定的手术团队进行。:最初纳入的998例患者中,共有847例患者完成了随访期。对每位患者都采用了三步法。复发率为1.89%。此外,还仔细检查了腰椎不稳的发生率和再次手术的必要性,从而全面呈现了治疗效果。:三步法成为解决腰椎间盘突出症的一种强大而有效的策略。这种结构化方法为年轻的脊柱外科医生确保了安全且有教育意义的手术体验。