segunda-feira, 2 de dezembro de 2013

ESTUDO MOSTRA QUE NÃO HÁ VANTAGEM NA COLOCAÇÃO DE PARAFUSOS NAS CIRURGIAS DE HÉRNIAS DE DISCO

Does the Fusion of a Lumbar Disc Herniation Improve the Clinical Outcome? An Investigation With a Minimum10-year Follow-up.
Journal of Spinal Disorders & Techniques.

AB Study Design: A retrospective long-term (minimum 10-year) follow-up and comparative study. Objective: To compare the clinical outcome of surgically treated primary lumbar discherniation by conventional discectomy alone and discectomy with posterolateral fusion without instrumentation. Summary of Background Data: Primary lumbar disc herniation is usually treated by discectomy alone. The long-term outcome of discectomy alone is generally satisfactory. However, the superiority of a discectomy alone in comparison to a discectomy with fusion for primary lumbar disc herniation has yet to be determined. Methods: Conventional discectomy without fusion was performed in 39 patients in hospital A (without-fusion group) and conventional discectomy with postero-lateral fusion without instrumentation was performed in 109 patients in hospital B (with-fusion group). The subjective symptoms (analgesic use, continuing gait time, 4-grade modified outcome criteria, numerical rating scale of pain and satisfaction with the operation and the Japanese version of the Roland-Morris Disability Questionnaire) and objective symptoms (SLR-T, manual muscle test and sensory disturbance) were assessed. Results: There were no differences detected in the subjective and objective symptoms between the without-fusion and with-fusion group. Conclusion: Routine fusion surgery for a primary lumbar disc herniation was therefore found to have no apparent benefit even in the long-term outcome. (C) 2013 by Lippincott Williams & Wilkins, Inc.

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