open access

Vol 50, No 2 (2016)
Review article
Submitted: 2015-11-19
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Treatment of lumbar disc herniation with radiculopathy. Clinical practice guidelines endorsed by The Polish Society of Spinal Surgery

Dariusz Latka, Grzegorz Miekisiak, Pawel Jarmuzek, Marcin Lachowski, Jacek Kaczmarczyk
DOI: 10.1016/j.pjnns.2015.12.001
·
Neurol Neurochir Pol 2016;50(2):101-108.

open access

Vol 50, No 2 (2016)
Review article
Submitted: 2015-11-19

Abstract

Introduction

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.

Aim

The 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 results

Twelve 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.

Conclusions

The 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

Introduction

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.

Aim

The 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 results

Twelve 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.

Conclusions

The 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.

Get Citation

Keywords

Spinal surgery, Herniated lumbar disc, Radiculopathy, Guidelines, Degenerative disc disease

About this article
Title

Treatment of lumbar disc herniation with radiculopathy. Clinical practice guidelines endorsed by The Polish Society of Spinal Surgery

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 50, No 2 (2016)

Pages

101-108

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

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