J Minim Invasive Spine Surg Tech.  2022 Apr;7(1):53-59. 10.21182/jmisst.2022.00409.

A Two-year Outcome of Various Techniques of Discectomy On Complications: A Multicentric Retrospective Study

Affiliations
  • 1Bombay Hospital & Medical Research Centre, Mumbai, India
  • 2Mumbai Spine Scoliosis and Disc Replacement Centre, Mumbai, India
  • 3Hinduja National Hospital and Medical Research Centre, Mumbai, India
  • 4Department of Spine Surgery, Ganga Hospital, Coimbatore, India
  • 5Indian Spinal Injuries Centre, New Delhi, India
  • 6Department of Spine Surgery, Sir Ganga Ram Hospital, New Delhi, India
  • 7Preetams Spine Surgery Centre, Madurai, India
  • 8Department of Orthopaedics, Modern Ortho Clinic & Care Hospital, Bhubaneswar, India
  • 9Department of Spine Services, Columbia Asia Hospital, Gurugram, India
  • 10Department of Orthopaedics, Smt. Kashibai Navale Medical College and General Hospital, Pune, India
  • 11Department of Orthopedic Surgery, Jupiter Hospital, Thane, India

Abstract


Objective
Various techniques of performing lumbar discectomy are prevalent, each having its rationale and claimed benefits. The authors ventured to assess the total complication rate of lumbar discectomy as well as the complication rates of individual complications, namely CSF leaks, superficial wound infections, deep wound infections, recurrence rates, re-operation rates, and wrong level surgery.
Methods
This was a retrospective study of patients operated using open discectomy (OD), microdiscectomy (MD), microendoscopic discectomy (MED), interlaminar endoscopic lumbar discectomy (IELD), transforaminal endoscopic lumbar discectomy (TELD), and Destandau techniques (DT) with a minimum follow-up of 2 years. The inclusion criteria were age>15 years, failed conservative treatment for 4-6 weeks, and the involvement of a single lumbar level.
Results
There is no statistically significant association between surgical technique and complications. The total complication rate was 12.89% in 946 operated cases. The most common complication was recurrence (5.81%), followed by re-operation (3.69%), CSF leak (1.90%), wrong level surgery (0.63%), superficial infection (0.52%) and deep infection (0.31%). There were minor differences in the incidence of complications between techniques.
Conclusion
This is the first study to compare the complication rates of all the prevalent discectomy techniques across the globe in 946 patients. Although there were minor differences in incidences of complications between individual techniques, there was no statistical significance. The various rates of individual complications provide a reference value for future studies related to complications following discectomy.

Keyword

Lumbar discectomy; Comparative study; Complications; Multi-centric study
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