Background
Methods
Study design and patients
Study design
Patients
Method of randomization
Inclusion criteria
Exclusion criteria
Follow up and outcome measures
Intervention
Postoperative care
Postoperative complications
Data analysis
Results
Demographic data
Primary outcome measure: (Oswestry disability index)
Secondary outcome measures
A/ VAS for back pain between group a and group B
B/ VAS for leg pain between group a and group B
C/ VAS for back pain in group a in different periods (multiple comparison)
Study variables | Periods of assessment | N | Mean | SD | P-value |
---|---|---|---|---|---|
VAS for back pain | VAS for back pain preoperatively | 30 | 7.73 | 0.78 | < 0.001* |
VAS for back pain 1 weeks postoperatively | 30 | 3.70 | 0.46 | ||
VAS for back pain 3 months postoperatively | 30 | 1.73 | 0.44 | ||
VAS for back pain 6 months postoperatively | 30 | 0.23 | 0.43 | ||
VAS for back pain 12 months postoperatively | 30 | 0.06 | 0.25 |
D/ VAS for back pain in group B in different periods (multiple comparison)
Study variables | Periods of assessment | N | Mean | SD | P-value |
---|---|---|---|---|---|
VAS for back pain | VAS for back pain preoperatively | 30 | 7.66 | 0.75 | < 0.001* |
VAS for back pain 1 weeks postoperatively | 30 | 2.20 | 0.40 | ||
VAS for back pain 3 months postoperatively | 30 | 0.43 | 0.50 | ||
VAS for back pain 6 months postoperatively | 30 | 0.23 | 0.43 | ||
VAS for back pain 12 months postoperatively | 30 | 0.20 | 0.40 |
E/ VAS for leg pain in group a in different periods (multiple comparison)
Study variables | Periods of assessment | N | Mean | SD | P-value |
---|---|---|---|---|---|
VAS for leg pain | VAS for leg pain preoperatively | 30 | 9.63 | 0.49 | < 0.001* |
VAS for leg pain 1 weeks postoperatively | 30 | 1.46 | 0.50 | ||
VAS for leg pain 3 months postoperatively | 30 | 0.56 | 0.50 | ||
VAS for leg pain 6 months postoperatively | 30 | 0.00 | 0.000 | ||
VAS for leg pain 12 months postoperatively | 30 | 0.00 | 0.000 |
F/ VAS for leg pain in group B in different periods (multiple comparison)
Study variables | Periods of assessment | N | Mean | SD | P-value |
---|---|---|---|---|---|
VAS for back pain | VAS for back pain preoperatively | 30 | 9.53 | 0.50 | < 0.001* |
VAS for back pain 1 weeks postoperatively | 30 | 1.33 | 0.47 | ||
VAS for back pain 3 months postoperatively | 30 | 0.46 | 0.50 | ||
VAS for back pain 6 months postoperatively | 30 | 0.00 | 0.00 | ||
VAS for back pain 12 months postoperatively | 30 | 0.00 | 0.00 |
C/ hospital stay, time of returning to daily activities and cost of surgery
Study variables | Study group | N | Mean | SD | t-test | P-value |
---|---|---|---|---|---|---|
Length of hospital stay (days) | Group A | 30 | 2.10 | 0.30 | 14.26 | < 0.001* |
Group B | 30 | 1.06 | 0.25 | |||
Time of returning to daily activity (days) | Group A | 30 | 7.33 | 0.84 | 14.73 | < 0.001* |
Group B | 30 | 4.03 | 0.88 | |||
Cost ($) | Group A | 30 | 1996.66 | 39.24 | −85.95 | < 0.001* |
Group B | 30 | 3003.33 | 50.74 |
C/ post-operative complications
D/ rate and time of the recurrence of disc herniation during 4 years of follow up
Study variables | Study group | Total | P-value | Odds | 95% CI | |
---|---|---|---|---|---|---|
Group A | Group B | |||||
Recurrence | 1.000 | 1.30 | 0.313-5.404 | |||
Yes | 5 (16.7) | 4 (13.3) | 9 (15.0) | |||
No | 25 (83.3) | 26 (86.7) | 51 (85.0) | |||
Total | 30 (100.0) | 30 (100.0) | 200 (100.0) |
E/ level of disability by ODI at time of recurrence of disc herniation during 4 years of follow up
E/ reoperation rate and type of surgery for recurrent disc herniation within 4 years of follow up
Discussion
Regarding Oswestry disability index
Regarding visual analogue scale for back pain
Regarding visual analogue scale for leg pain
Regarding hospital stay, return to daily activities and cost of surgery
Regarding post-operative complications
Regarding rate and time of the recurrence of disc herniation with period of 4 years of follow up
Study variables | Study group | N | Mean | SD | t-test | P-value |
---|---|---|---|---|---|---|
Time of recurrence (months) | Group A | 5 | 29.00 | 6.08 | 0.778 | |
Group B | 4 | 27.75 | 6.70 |
Regarding level of disability by ODI at time of recurrent disc herniation with period of 4 years of follow up
Regarding re-operation rate and type of intervention for recurrent disc herniation with period of 4 years of follow up
Comparing our study with other studies
Henriksen et al. study | Our study |
---|---|
Microscopic procedure does not shorten the length of a stay at the hospital. | There is significant decrease in length of hospital stay with microscopic procedure. (P < 0.001) |
Study of Tureyen K | Our study |
---|---|
The length of postoperative inpatient stay was 1 day in both groups. (p > 0.05) | There is significant decrease in length of hospital stay with microscopic procedure. (P < 0.001) |
Patients in the microsurgery-treated group returned to work in less time. (p < 0.001) | There is significant less time needed to return to daily activities with microscopic procedure. (P < 0.001) |
Katayama et al. study | Our study |
---|---|
Statistically significant differences were observed in duration of hospitalization with microscopic procedure. | There is significant decrease in length of hospital stay with microscopic procedure. (P < 0.001) |
Statistically significant differences were observed in postoperative VAS for lumbar pain with microscopic procedure. | There were significant differences between means of post-operative VAS for back pain between these two groups after 1 week (t = 13.28, P = < 0.001*) and after 3 months of operation (t = 10.54, P = < 0.001*), while non-significant differences between two groups after 6 months (t = 0.00, P = 1.000) andtwelve months of operation. (t = −1.523.00, P = 0.134). |
Porchet et al. study | Our study |
---|---|
There were no group differences in duration of hospital stay. (P > 0.05) | There is significant decrease in length of hospital stay with microscopic procedure. (P < 0.001) |
There was no clinically relevant difference in outcome after lumbar disc excision dependent on the use of the microscope. | There is significant less time needed to return to daily activities with microscopic procedure. (P < 0.001) |