Avtor/Urednik		Bunc, Gorazd; Strnad, Simona
Naslov		Dolgoročni rezultati mikrodiscektomij v primerjavi s kratkoročnimi
Prevedeni naslov		Long-term outcome of microdiscectomies in comparison with short-term results
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 67, št. 9
Leto izdaje		1998
Obseg		str. 519-24
Jezik		slo
Abstrakt		Bakground. Our aim was to assess the long-term autcome of operative treatment of lumbar herniated discs 8.7 years after microdiscectomy. Methods. Out of 100 patients operated between 1987 and 1989, we recently reassessed 86 patients by means of a questionnaire or on outpatient basis using the same outcome scale (MB scale) as we did 17 months after surgery, and by means of the Prolo outcome scale. We made a statistical comaprison of short-and long-term results as a whole and between different subgroups. Results. Considering the excellent and good results together as satisfactory, there are 94.1% long-term in comparison with 95,3% short-term satisfactory results. Comparable results are also obtained with the Prolo outcome scale when rates 7, 8, 9 and 10 are taken together as satisfactory. Patients with sedentary work and patients with preoperative pain of less than 3 months duration have a statistically better outcome (p < 0,05) than those with strenous work and more than 3 months of preoperative pain. There is slightly more low back pain but fewer radicular and neurological problems in the legs. 40.7% are doing the same work as before, 25.6% are categorized in the IIIrd, 8.1% in the IInd category of disablement, 25.6% of patients are retired. There is a 4.65% postoperative complication rate, 2% of reoperations in the first postoperative yer and 4.3% after 6 years (together a 6.3% reoperative rate). Conclusions. Operative results obtained by means of BM and Prolo scales 8.7 years after microdiscectomy are still good enough and comparable with similar series in the literature. They are only slightly but not statistically les favorable than the short-term results. On the basis of these facts we can conclude that microdiscectomy acc. to Caspar is a method offering good long-term results.(Abstract truncated at 2000 characters)
Izvleček		Izhodišča. Oceniti želimo dolgoročnost operativnega zdravljenja lumbalnih diskus hernij 8,7 leta po mikrodiscektomiji. Metode. Od 100 bolnikov, operiranih od 1987. do 1989. leta, ponovno ocenimo 86 bolnikov s pomočjo anketnega vprašalnika ambulantnega pregleda. Bolnike ocenimo z isto ocenjevalno lestvico (MB lestvica) kot pri prvem ocenjevanju po 17 mesecih in s pomočjo Prolove lestvice. Statistično primerjamo kratko in dolgoročno uspešnost zdravljenja v celoti in med različnimi podskupinami operiranih bolnikov. Rezultati. Dolgoročnih zadovoljivih rezultatov je 94,1% v primerjavi s 95,3% pri kratkoročnem spremljanju bolnikov. Tak rezultat dobimo, če povežemo ocene dobro in odlično vpodskupino zadovoljivih rezultatov. Primerljive rezultate, kot jih dobimo po MB lestvici, prikazuje tudi Prolova lestvica, če povežemo ocene 7, 8, 9 in 10. Statistično (p < 0,05) boljše daljnoročne rezultate ugotovimo pri bolnikih s fizično manj obremenjenimi poklici in pri bolnikih z manj kot 3 mesece trajajočo predoperativno bolečino. Bolniki imajo nekoliko večje težave v križu, radikularna in nevrološka problematika v nogah pa upada. Enako delo kot prej opravlja 40,7% bolnikov, 25,6% jih je v III. kategoriji 8,1% v II, 25,6% je upokojenih. Pooperativnih zapletov je 4,65%, reoperacij v prvem letu 2%, povprečno šest let po prvem posegu pa še 4,3%. Skupno je reoperacij 6,3%. Zaključki. Operativno zdravljenje z mikrodiscektomijo 8,7 leta po prvem posegu, ocenjeno z MB, kot tudi s Prolovo lestvico kaže še vedno dober dolgoročni rezultat, ki je primerljiv s podobnimi v literaturi in je le nekoliko, vendar ne statistično značilno slabši od kratkoročnih. Na osnovi tega sklepamo, da je mikrodiscektomija po Casparju metoda, ki daje tudi dolgoročno zadovoljive rezultate.(Izvleček prekinjen pri 2000 znakih)
Deskriptorji		INTERVERTEBRAL DISK DISPLACEMENT DISKECTOMY POSTOPERATIVE COMPLICATIONS MICROSURGERY TREATMENT OUTCOME