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Treatment of lumbar disc herniation with radiculopathy. Clinical practice guidelines endorsed by The Polish Society of Spinal Surgery
Affiliations- Department of Neurosurgery, Regional Medical Center, Opole, Poland
- Department of Neurosurgery, Specialist Medical Center, Polanica-Zdroj, Poland
- Department of Neurosurgery, Regional Neurosurgery and Neurotrauma Center, Zielona Gora, Poland
- 1 st Department of Radiology, Medical University of Warsaw, Chałubińskiego str 5, 02-004 Warsaw, Poland
- Department of Orthopedics and Traumatology, Poznan University of Medical Sciences, Poznan, Poland
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Abstract
Herniated lumbar disc (HLD) is arguably the most common spinal disorder requiring surgical intervention. Although the term is fairly straightforward, the exact pathology and thus the clinical picture and natural history may vary. Therefore, it is immensely difficult to formulate universal guidelines for surgical treatment.
AimThe aim of this paper is to organize the terminology and clear the inconsistencies in phraseology, review treatment options and gather available published evidence to address the clinical questions to create a set of clinical guidelines in relevant to the topic.
Methods and resultsTwelve queries, addressing optimal surgical treatment of the HLD have been formulated. The results, based on the literature review are described in the present work. The final product of the analysis was a set of guidelines for the surgical treatment of symptomatic HLD. Categorized into four tiers based on the level of evidence (I–III and X), they have been designed to assist in the selection of optimal, effective treatment leading to the successful outcome.
ConclusionsThe evidence based medicine (EBM) is becoming ever more popular among spinal surgeons. Unfortunately this is not always feasible. Lack of uniform guidelines and numerous conflicts of interest introduce flaws in the decision making process. The key role of experts and professional societies is to provide high value recommendation based on the most current literature. Present work contains a set of guidelines for the surgical treatment of HLD officially endorsed by the Polish Spine Surgery Society.
Abstract
Herniated lumbar disc (HLD) is arguably the most common spinal disorder requiring surgical intervention. Although the term is fairly straightforward, the exact pathology and thus the clinical picture and natural history may vary. Therefore, it is immensely difficult to formulate universal guidelines for surgical treatment.
AimThe aim of this paper is to organize the terminology and clear the inconsistencies in phraseology, review treatment options and gather available published evidence to address the clinical questions to create a set of clinical guidelines in relevant to the topic.
Methods and resultsTwelve queries, addressing optimal surgical treatment of the HLD have been formulated. The results, based on the literature review are described in the present work. The final product of the analysis was a set of guidelines for the surgical treatment of symptomatic HLD. Categorized into four tiers based on the level of evidence (I–III and X), they have been designed to assist in the selection of optimal, effective treatment leading to the successful outcome.
ConclusionsThe evidence based medicine (EBM) is becoming ever more popular among spinal surgeons. Unfortunately this is not always feasible. Lack of uniform guidelines and numerous conflicts of interest introduce flaws in the decision making process. The key role of experts and professional societies is to provide high value recommendation based on the most current literature. Present work contains a set of guidelines for the surgical treatment of HLD officially endorsed by the Polish Spine Surgery Society.
Keywords
Spinal surgery, Herniated lumbar disc, Radiculopathy, Guidelines, Degenerative disc disease
About this articleTitle
Treatment of lumbar disc herniation with radiculopathy. Clinical practice guidelines endorsed by The Polish Society of Spinal Surgery
Journal
Neurologia i Neurochirurgia Polska
Issue
Article type
Review Article
Pages
101-108
Page views
293
Article views/downloads
672
DOI
10.1016/j.pjnns.2015.12.001
Bibliographic record
Neurol Neurochir Pol 2016;50(2):101-108.
Keywords
Spinal surgery
Herniated lumbar disc
Radiculopathy
Guidelines
Degenerative disc disease
Authors
Dariusz Latka
Grzegorz Miekisiak
Pawel Jarmuzek
Marcin Lachowski
Jacek Kaczmarczyk
