Recently, minimally invasive surgery for the treatment of sciatica is not better

A comparison of surgical treatment of sciatica that the minimally invasive procedure known as tubular diskectomy not a substantial difference in the improvement of functional disability compared with the joint operation, conventional microdiskectomy, according to a study in July 8 edition of JAMA.

Lumbosakralen sciatica or radicular syndrome affects millions of people worldwide and is, in general, by the disc herniation. Surgery in patients with pain who are not on the conservative treatment, with the common surgical procedures microdiskectomy (distance of the injured tissue and the piece of hard disk). The mini-invasive technique of transmuscular tubular diskectomy was introduced in 1997. "The logic behind the place of traditional Subperiosteal dissection muscle by muscle-splitting approach transmuscular tubular diskectomy less tissue damage, resulting in an acceleration of the recovery, but with long-term results. Patient may be expected to that reduces post-operative back pain, so that the more rapid mobilization and shorter hospitalization and faster return to work and daily activities, "the authors write. Although this process has been established for the rate of recovery, there is a lack of evidence, according to background information in the article.

Mark S. Art, MD, Medical Center of the Hague, The Hague, Netherlands, and colleagues, a multicenter study to determine the results and rest periods in patients with lumbar disc herniation with tubular or conventional diskectomy microdiskectomy. The study involved 328 patients, aged 18 to 70 years, the persistence of pain in the legs (more than 8 weeks), on the hard disk of lumbar herniation. Patients were randomized either to tubular diskectomy (n = 167) or conventional microdiskectomy (n = 161). Functioning, pain and self-report of recovery were carried out using a questionnaire or survey.

The researchers found: "The benefits of faster rates of recovery after sciatic tubular diskectomy not be reproduced in this double blind study. This study found evidence that the takeover price for the mini-invasive diskectomy and tubular conventional microdiskectomy similar. However, differences in pain intensity and prices for the conventional approach microdiskectomy. "

1 year, 107 of the 156 patients (69%), tubular diskectomy reported a good recovery of 151 vs. 120 patients (79%) for conventional microdiskectomy.

"Although the mini-invasive technique of the tubular diskectomy seemed a surgical method for treating sciatica, our data are not higher for a recovery compared to traditional microdiskectomy. On the contrary, patients were divided tubular diskectomy wrong in regard to the leg and back pain and fewer patients reported complete 1 year, "the authors conclude.