In:
Global Spine Journal, SAGE Publications, Vol. 10, No. 1 ( 2020-02), p. 63-68
Abstract:
Retrospective cohort study. Objective: To investigate radiological differences in lumbar disc herniations (herniated nucleus pulposus [HNP]) between patients receiving microscopic lumbar discectomy (MLD) and nonoperative patients. Methods: Patients with primary treatment for an HNP at a single academic institution between November 2012 to March 2017 were divided into MLD and nonoperative treatment groups. Using magnetic resonance imaging (MRI), axial HNP area; axial canal area; HNP canal compromise; HNP cephalad/caudal migration and HNP MRI signal (black, gray, or mixed) were measured. T test and chi-square analyses compared differences in the groups, binary logistic regression analysis determined odds ratios (ORs), and decision tree analysis compared the cutoff values for risk factors. Results: A total of 285 patients (78 MLD, 207 nonoperative) were included. Risk factors for MLD treatment included larger axial HNP area ( P 〈 .01, OR = 1.01), caudal migration, and migration magnitude ( P 〈 .05, OR = 1.90; P 〈 .01, OR = 1.14), and gray HNP MRI signal ( P 〈 .01, OR = 5.42). Cutoff values for risks included axial HNP area (70.52 mm 2 , OR = 2.66, P 〈 .01), HNP canal compromise (20.0%, OR = 3.29, P 〈 .01), and cephalad/caudal migration (6.8 mm, OR = 2.43, P 〈 .01). MLD risk for those with gray HNP MRI signal (67.6% alone) increased when combined with axial HNP area 〉 70.52 mm 2 (75.5%, P = .01) and HNP canal compromise 〉 20.0% (71.1%, P = .05) cutoffs. MLD risk in patients with cephalad/caudal migration 〉 6.8 mm (40.5% alone) increased when combined with axial HNP area and HNP canal compromise (52.4%, 50%; P 〈 .01). Conclusion: Patients who underwent MLD treatment had significantly different axial HNP area, frequency of caudal migration, magnitude of cephalad/caudal migration, and disc herniation MRI signal compared to patients with nonoperative treatment.
Type of Medium:
Online Resource
ISSN:
2192-5682
,
2192-5690
DOI:
10.1177/2192568219856345
Language:
English
Publisher:
SAGE Publications
Publication Date:
2020
detail.hit.zdb_id:
2648287-3
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