Which treatments fir lumbar disc disease are being developed?

Updated: Sep 25, 2018
  • Author: Kamran Sahrakar, MD, FACS; Chief Editor: Brian H Kopell, MD  more...
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Answer

Most areas of controversy are delineated within the above text. The major controversies are outlined in this section.

The duration of conservative management has been debated since the disease was identified. As surgical treatments become less invasive and medications change, the role and duration of conservative management will change as well.

Endoscopic operations are becoming safer and more prevalent. Although many microdiscectomies are now being performed in the outpatient setting, the impetus for even less invasive procedures continues. In fact, the endoscopic approach is even used in the traditionally more technically demanding recurrent cases. [31] The theoretical advantage of reduced muscle injury in the endoscopic approach is somewhat in question as CPK and multifidus muscle atrophy are not significantly different when compared to conventional microdiscectomy. [32]

The role of stabilization in lumbar disc surgery is very unclear. An increasing number of patients are having extensive fusions as the first-line management of lumbar radiculopathy secondary to disc herniations. However, the indications for stabilization need to be better established.


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