Open Access, Peer-reviewed
pISSN 2093-4378
eISSN 2093-4386
    J Korean Soc Spine Surg. 2013 Dec;20(4):129-134. Korean.
    Published online Dec 31, 2013.
    https://doi.org/10.4184/jkss.2013.20.4.129
    © Copyright 2013 Korean Society of Spine Surgery
    Original Article

    Comparison of Microscopic Lumbar Discectomy Between under Local and General Anesthesia in Lumbar Disc Herniation

    Hyoung-Yeon Seo, M.D. and Hong-An Lim, M.D.
      • Department of Orthopedic Surgery, Chonnam National University Hospital, Gwangju, Korea.
    • Corresponding author: Hong-An Lim, M.D. Department of Orthopedic Surgery, Chonnam National University Hospital, 8 Hak-dong, Dong-gu, Gwangju, 501-757, Korea. TEL: 82-62-220-6336, FAX: 82-62-225-7794, Email: excellent35@hanmail.net
    Received August 27, 2013; Revised October 18, 2013; Accepted December 10, 2013.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    Study Design

    Retrospective study.

    Objectives

    To evaluate the effectiveness of microdiscectomy under local anesthesia in comparison with general anesthesia.

    Summary of Literature Review

    No comparative studies regarding the outcomes of microdiscectomy under local and general anesthesia could be found in the literature.

    Materials and Methods

    Between May 2000 and June 2004, 88 patients who underwent microdiscectomy under local anesthesia (n=50, local anesthesia group) or under general anesthesia (n=38, general anesthesia group) were selected and included in this study with a follow up period more than 3 years. The operation time and duration of hospital stay were documented. The Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI) were used to evaluate the degree of symptom relief. The patient satisfaction was evaluated using the MacNab's criteria and postoperative complications.

    Results

    Between both groups there is no significant operation time difference. However, the average hospital stay duration in the general anesthesia group was 7.3 days, while it was 4.7 days in the local anesthesia group (P<0.05). The VAS and ODI scores were improved in both groups. Thirty-two cases (84.2%) of the general anesthesia group and 40 cases (80%) of the local anesthesia group showed satisfied results by the MacNab's criteria with no statistically significant difference (P>0.05). Three patients in the general anesthesia group and 7 patients in the local anesthesia group needed a reoperation.

    Conclusions

    A microdiscectomy under local anesthesia shows faster recovery period. But it shows also a relative high revision rate. In patients with old age and underlying disease, local anesthesia can be used for the microdiscectomy selectively and careful exploration of the herniated disc is required.

    Keywords
    Lumbar disc herniation; Microdiscectomy; Local anesthesia

    Figures

    Fig. 1
    Visual Analogue Scale(VAS) score after microdiscectomy. Early postoperative VAS score of the local anesthesia group is lower than the general anesthesia group. But, there is no statistical difference between general anesthesia group and local anesthesia group(P=0.082).

    Fig. 2
    Graph showing the Oswestry Disability Index (ODI) score after microdiscectomy. There is no statistical difference between general anesthesia group and local anesthesia group(P=0.088).

    Tables

    Table 1
    Demographic Data of Patients

    Table 2
    Results of microdiscectomy under general and local anesthesia

    Table 3
    Reoperation cases of microdiscectomy under general and local anesthesia

    References

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    MeSH Terms
    Anesthesia, General*
    Anesthesia, Local
    Diskectomy*
    Follow-Up Studies
    Humans
    Intervertebral Disc Displacement
    Length of Stay
    Patient Satisfaction
    Reoperation
    Retrospective Studies
    Metrics
    Share
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