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" Comparison of open surgical discectomy versus plasma-laser nucleoplasty in patients with single lumbar disc herniation "
\ Masih Kouchakzadeh
; Saeid Abrishamkar
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Isfahan University of Medical Sciences
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| Document Type
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Latin Dissertation
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English
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| Record Number
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107552
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| Doc. No
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T17095
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WE740,K88c,2016
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| Main Entry
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Kouchakzadeh, Masih
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| Title & Author
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Comparison of open surgical discectomy versus plasma-laser nucleoplasty in patients with single lumbar disc herniation\ Masih Kouchakzadeh
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| College
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Schools, Medical
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| Date
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, 2016
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Speciality
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| field of study
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Neurosurgery
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{No paging}: diag, tab
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| Note
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This is a research dissertation with project ID: 393437
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مسیح کوچک زاده
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| Abstract
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Background: Intervertebral disc herniation is a major cause of low back pain. Several treatment methods are available for lumbar discherniation including Chemonucleolysis, open surgery, nucleoplasty, laser disc decompression, and intradiscal electrothermal therapy. Thehigh prevalence of lumbar disc herniation necessitates a minimally invasive yet effective treatment method. In this study, we comparedthe outcomes of open surgery and nucleoplasty method in patients with single lumbar disc herniation. Materials and Methods: Thisstudy was a noninferiority randomized clinical trial conducted in one of the University Hospitals of Isfahan Medical University; TheAlzahra Hospital. About 200 patients with the diagnosis of lumbar disc herniation were recruited and were assigned to either thetreatment or control groups using block randomization. One group received open surgery and the other group received nucleoplasty asthe method of treatment. Patients were revisited at 14 days, 1, 2, 3 months, and 1-year after surgery and were assessed for the followingvariables: Lower back pain, lower limb pain, common complications of surgery (e.g., discitis, infection and hematoma) and recurrence ofherniation. Results: The mean (standard deviation) severity of low back pain was reduced from 6.92 (2.5) to 3.43 (2.3) in the nucleoplastygroup (P = 0.04) and from 7.5 (2.2) to 3.04 (1.61) in the discectomy group (P = 0.73). Between group difference was not statisticallysignificant (P = 0.44), however, time and treatment interaction was significant (P = 0.001). The level of radicular pain evaluated 1 yearafter treatment was reduced from 8.1 (1.2) to 2.9 (1.2) (P = 0.004) and from 7.89 (2.1) to 3.6 (2.5) (P =0.04) in the discectomy and thenucleoplasty groups respectively, significant interaction between time and treatment options was observed (P < 0.001) while there wasno significant difference between two treatment groups (P = 0.82). Conclusion: Our results show that while nucleoplasty is as effectiveas open discectomy in the treatment of lumbar disc herniation, it is also less invasive with higher patient compliance. Taking factor suchas decreased cost and duration of the surgery, as well as faster recovery in patients into account; we suggest considering nucleoplastyas an effective method of treatment in patients with single-level disc herniation.
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| Descriptor
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Intervertebral Disc Displacement
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Diskectomy
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Nucleoplasmins
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Hernia
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| Added Entry
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Abrishamkar, Saeid, Thesis advisor
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| Translated Title Supplied by Cataloguer
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مقایسه دیسککتومی جراحی باز در مقابل نوکلئوپلاستی پلاسما لیزر در بیماران مبتلا به تک فتق دیسک کمری
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