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Sciatica Outcomes Not Better After Tubular Diskectomy

Last Updated: July 07, 2009.

In patients with sciatica, minimally invasive treatment with tubular diskectomy does not significantly improve functional disability compared to conventional microdiskectomy, and may be associated with poorer outcomes, according to a study in the July 8 Journal of the American Medical Association.

TUESDAY, July 7 (HealthDay News) -- In patients with sciatica, minimally invasive treatment with tubular diskectomy does not significantly improve functional disability compared to conventional microdiskectomy, and may be associated with poorer outcomes, according to a study in the July 8 Journal of the American Medical Association.

Mark P. Arts, M.D., of the Medical Center Haaglanden in the Hague, Netherlands, and colleagues randomly assigned 328 patients to receive either tubular diskectomy or conventional microdiskectomy.

During the entire follow-up period of 52 weeks, the researchers found no statistically significant differences between the tubular diskectomy and conventional microdiskectomy groups in the mean Roland-Morris Disability Questionnaire score (6.2 versus 5.4). However, at 52 weeks they found statistically significant differences in favor of conventional microdiskectomy (4.7 tubular diskectomy versus 3.4 conventional microdiskectomy). While there was improvement in pain for both groups based on the visual analog scale, they found that patients who underwent conventional microdiskectomy reported less leg pain (14.1 mm versus 18.3 mm) and back pain (19.7 mm versus 23.2 mm). After one year, they also found that rates of self-reported good recovery were higher in the conventional microdiskectomy group (79 versus 69 percent).

"The expected treatment benefit of a faster rate of recovery from sciatica after tubular diskectomy could not be reproduced by this double-blind study," the authors write. "This study revealed evidence that the rates of recovery for the minimally invasive tubular diskectomy and conventional microdiskectomy were similar. In contrast, the overall differences in pain intensity and recovery rates favored the conventional microdiskectomy approach."

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