European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Randomized Controlled Trial
Surgical technique and effectiveness of microendoscopic discectomy for large uncontained lumbar disc herniations: a prospective, randomized, controlled study with 8 years of follow-up.
There is a long-held concept among spine surgeons that endoscopic lumbar discectomy procedures are reserved for small-contained disc herniation; 8-year follow-up has not been reported. The purpose of this study is to assess microendoscopic discectomy (MED) in patients with large uncontained lumbar disc herniation (the antero-posterior diameter of the extruded fragment is 6-12 mm or more on axial cuts of MRI) and report long-term outcome. ⋯ Large, uncontained, lumbar disc herniations can be sufficiently removed using MED which is an effective alternative to open discectomy procedures with remarkable long-term outcome. Although the neurological outcome of the two procedures is the same, the morbidity of MED is significantly less than open discectomy. Maximum benefit can be gained if we adhere to strict selection criteria. The optimum indication is single- or multi-level radiculopathy secondary to a single-level, large, uncontained, lumbar disc herniation.
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Randomized Controlled Trial
Effect of pulsed radiofrequency in treatment of facet-joint origin back pain in patients with degenerative spondylolisthesis.
Degenerative spondylolisthesis is a well-recognized source of low back pain mainly induced by facet joint pain. Pulsed radiofrequency (PRF) allows heat dissipation, thus producing a temporary injury that affects only type C fibers responsible for pain conduction. ⋯ Our results demonstrated that the application of PRF might be more effective than steroid and bupivacaine injection in decreasing back pain due to degenerative facet pain and improvement in function of patients.