Navigation Links
Minimally Invasive Surgery Not Better for Sciatica
Date:7/7/2009

Faster recovery, less pain with conventional operation

TUESDAY, July 7 (HealthDay News) -- Minimally invasive surgery for the excruciating back pain that can be caused by sciatica didn't work as well as the conventional procedure in a Dutch study.

"The expected treatment benefit of a faster rate of recovery from sciatica after tubular diskectomy could not be reproduced by this double-blind study," according to a report in the July 8 issue of the Journal of the American Medical Association.

Orthopedic surgeons at the Medical Center Haaglanden studied 328 people who underwent surgery for sciatic pain, and found that "the overall differences in pain intensity and recovery rates favored the conventional microdiskectomy."

Surgery is done to remove the portion of a disk that has ruptured and causes pain by pressing on the sciatic nerve. The older method, microdiskectomy, is done through a larger incision than that used for transmuscular tubular diskectomy, the minimally invasive technique that was introduced in 1997 and has gained wide popularity. But only a few studies comparing results of the two techniques have been reported.

"The reason why it [minimally invasive surgery] did not work could be because our conventional technique uses a small incision as well," said study author Dr. Mark P. Arts.

Minimally invasive surgery might still be recommended in some cases, Arts noted. "We are still working on our subgroup analysis, but possibly the tubular diskectomy is indicated in obese patients in whom a large incision and exposure is inevitable," he said.

But more patients probably will prefer the conventional approach, Arts said. "We will discuss the results of our study with our patients and their prejudiced opinion of small being better will probably change into, 'Do what's best for me,'" he said.

The results of the Dutch study were no surprise to Dr. Todd J. Albert, director of the department of orthopedic surgery at the Rothman Institute of Thomas Jefferson University in Philadelphia.

"We have people in our unit who did a similar study and found very similar results," Albert said. That study has been submitted to a medical journal for publication, he noted.

Any minimally invasive surgical technique is bound to be popular "because the public wants a less invasive procedure if it accomplishes the same thing," Albert said. "Sometimes it pans out and sometimes it doesn't. With knee surgery it has, but minimally invasive hip surgery, which was a big rage a few years ago, is not necessarily better."

In his practice, Albert said, surgery for sciatic pain is done with a procedure halfway between the conventional and minimally invasive methods. "Maybe my incision is a half a centimeter longer than for microdiskectomy," he said. "We find the window where the disk is pressing on the nerve and push it out. It is much more like the open-surgery approach."

In practical terms, the real question about surgery for sciatica is not which technique should be used but whether surgery should be done, said Dr. Michael Y. Wang, an associate professor of neurological surgery and rehabilitation medicine at the University of Miami Miller School of Medicine.

"In general, the answer is, when you have a neurological deficit or intractable pain or a problem threatening loss in terms of neurological function," Wang said. The most common reason is to ease pain, he said.

The differences shown in the Dutch study are not great enough to say that one procedure is clearly preferable over the other, Wang noted. "I use the conventional technique even though I'm a minimally invasive surgeon," he said. "For sciatica, the minimally invasive method is too complicated and involved."

The Dutch results are not directly transferable to the United States for several reasons, Wang said. For example, those who had surgery in the study stayed an average of 3.3 days in the hospital. Such a long stay is virtually unheard of in the United States, where hospital discharge is almost always done a day or two after surgery, Wang said.

More information

Sciatica and its treatment are described by the U.S. National Library of Medicine.



SOURCES: Mark P. Arts, M.D., neurosurgeon, Medical Center Haaglanden, the Hague, Netherlands; Todd J. Albert, M.D., director, department of orthopedic surgery, Rothman Institute of Thomas Jefferson University, Philadelphia; Michael Y. Yang, M.D., associate professor, neurological surgery and rehabilitation medicine, University of Miami Miller School of Medicine; July 8, 2009, Journal of the American Medical Association


'/>"/>
Copyright©2009 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Minimally Invasive Heart Surgery Research Wins N.I.H. Award
2. Novadaq launches PINPOINT: Companys first minimally invasive imaging system
3. Published Results Using AtriCure Minimally Invasive Products
4. Awake the Movie Highlights the Need for Goldilocks Anesthesia, Says Dr. Barry L. Friedberg, Developer of Bispectral Index (BIS) Monitored Propofol Ketamine Sedation, Now Trademarked as Minimally Invasive Anesthesia (MIA)(R)
5. Z-shaped incision enhances minimally-invasive surgery
6. Z-shaped incision enhances minimally invasive surgery
7. Minimally Invasive Surgery Fixes Aneurysms
8. Northwestern Memorials Heart Center Pioneers Minimally Invasive Surgery That Corrects Irregular Heart Beat
9. Minimally invasive fibroid treatment fares well in multicenter trial
10. Women Can Now Learn About Minimally Invasive Gynecologic Treatments at AAGL.org
11. Robot-assisted minimally-invasive CABG surgery
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Minimally Invasive Surgery Not Better for Sciatica
(Date:8/16/2017)... Texas (PRWEB) , ... August 16, 2017 , ... Ten ... Credit Union's Stars in the Classroom and will win a visit by a Houston ... grades K-12 who are at least five years old can visit texanschecking.com/stars to nominate ...
(Date:8/16/2017)... ATLANTA, Georgia (PRWEB) , ... August 16, 2017 ... ... practice in Atlanta, opened their doors. They celebrate 30 years in business this ... to create an up-to-date, inviting, tranquil space to serve their patients. , ...
(Date:8/16/2017)... ... August 16, 2017 , ... Maury Regional Health has announced a ... By broadly deploying AccuVein devices, Maury Regional Medical Center is making vein visualization part ... of a needle stick and more importantly, helps our staff members locate a vein ...
(Date:8/16/2017)... New Cumberland, PA (PRWEB) , ... August 16, 2017 , ... ... announced today it has successfully opened clubfoot clinics in all 29 Indian states—bringing the ... its newest clinic in Kangra, Himachal Pradesh, the nonprofit organization is on track to ...
(Date:8/16/2017)... ... August 16, 2017 , ... Fusion Flix Inc., a Telly ... over four countries and millions of viewers in a partnership with the Amazon Video ... On-Demand and fully available on Blu Ray disc in 2018. Proceeds will be going ...
Breaking Medicine News(10 mins):
(Date:7/31/2017)... -- Three Tru-D SmartUVC robots have arrived at Brian Allgood ... Tru-D, short for "Total Room Ultraviolet Disinfection," is a 5-foot-5 germ-killing robot ... (ES) professional cleans the area with traditional cleaning protocols. ... Tru-D fights germs at Army hospitals ... "Although the BAACH has a very low infection rate, ...
(Date:7/27/2017)... -- Zimmer Biomet Holdings, Inc. (NYSE and SIX: ZBH) today reported ... The Company reported second quarter net sales of $1.954 ... period, and an increase of 2.1% on a constant ... from the LDR Holding Corporation acquisition, second quarter 2017 ... or 0.3% on a constant currency basis. ...
(Date:7/26/2017)... BEACH, Fla. , July 26, 2017 ... of enrollment of our clinical trial evaluating Altemia TM ... Cell Anemia (SCA) and Sickle Cell Disease (SCD). The ... to evaluate the efficacy and safety of Altemia TM ... trial is conducted under US IND 125274. ...
Breaking Medicine Technology: