Trial reportEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2011
Does minimally invasive lumbar disc surgery result in less muscle injury than conventional surgery? A randomized controlled trial.
Trial report in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
42 citing papers in PubMed, 6 syntheses or guidelines pooled it, 115 citations in OpenAlex.
- Comparative efficacy and safety of three surgical procedures for the treatment of lumbar disc herniation: a Bayesian-based network analysis.BMC surgery · 2025Pooled it
- Meta-analysis of percutaneous transforaminal endoscopic discectomy vs. fenestration discectomy in the treatment of lumbar disc herniation.Der Orthopade · 2018Pooled it
- Microendoscopic discectomy versus open discectomy for lumbar disc herniation: a meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2016Pooled it
- Minimally invasive discectomy versus microdiscectomy/open discectomy for symptomatic lumbar disc herniation.The Cochrane database of systematic reviews · 2014Pooled it
- The safety and efficacy of minimally invasive discectomy: a meta-analysis of prospective randomised controlled trials.International orthopaedics · 2014Pooled it
- Surgical techniques for sciatica due to herniated disc, a systematic review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2012Pooled it
- A new hernia blocking system to prevent recurrent lumbar disc herniation: surgical technique, intraoperative findings and six-months post-operative outcomes.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Trial
- Minimally invasive tubular lumbar microdiscectomy in pediatric patients: a single-center case series.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Article
- From Incision to Prescription: Unraveling Pain and Opioid Use in Adult Spinal Deformity Surgery.International journal of spine surgery · 2025Article
- The Microscope and the Tubular System: Trend or Real Benefit in Lumbar Spinal Stenosis and Disc Herniation?Cureus · 2025Article
- Article
- Risk Analysis of Neurological Deterioration Associated With Fluid Insufflation in Uniportal Spine Endoscopy: A Case Series and Literature Review.International journal of spine surgery · 2025Article
- Effect of Monopolar Electrocautery and Blunt Dissection on Muscle Damage and Inflammation in Patients Undergoing Lumbar Microdiscectomy.Medical science monitor : international medical journal of experimental and clinical research · 2025Article
- Earthing as a Supportive Therapy for Post-Spinal Surgery Recovery.Journal of clinical medicine · 2025Article
- Qualitative Evaluation of Paraspinal Musculature After Minimally Invasive Lumbar Decompression: A Prospective Study.International journal of spine surgery · 2024Article
- Magnetic Resonance Imaging Evaluation of Multifidus Muscle in Patients with Low Back Pain after Microlumbar Discectomy Surgery.Journal of clinical medicine · 2023Article
- Minimally Invasive Tubular Lumbar Discectomy Versus Conventional Open Lumbar Discectomy: An Observational Study From the Canadian Spine Outcomes and Research Network.Global spine journal · 2023Article
- Endoscopic Spinal Surgery (BESS and UESS) Versus Microscopic Surgery in Lumbar Spinal Stenosis: Systematic Review and Meta-Analysis.Global spine journal · 2022Review
- Microendoscopic lumbar discectomy with general versus local anesthesia: A systematic review and meta-analysis.North American Spine Society journal · 2022Review
- Magnetic Resonance Imaging Documentation of Approach Trauma With Lumbar Endoscopic Interlaminar, Translaminar, Compared to Open Microsurgical Discectomy.International journal of spine surgery · 2022Article
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The concept of minimally invasive lumbar disc surgery comprises reduced muscle injury. The aim of this study was to evaluate creatine phosphokinase (CPK) in serum and the cross-sectional area (CSA) of the multifidus muscle on magnetic resonance imaging as indicators of muscle injury. We present the results of a double-blind randomized trial on patients with lumbar disc herniation, in which tubular discectomy and conventional microdiscectomy were compared. In 216 patients, CPK was measured before surgery and at day 1 after surgery. In 140 patients, the CSA of the multifidus muscle was measured at the affected disc level before surgery and at 1 year after surgery. The ratios (i.e. post surgery/pre surgery) of CPK and CSA were used as outcome measures. The multifidus atrophy was classified into three grades ranging from 0 (normal) to 3 (severe atrophy), and the difference between post and pre surgery was used as an outcome. Patients' low-back pain scores on the visual analogue scale (VAS) were documented before surgery and at various moments during follow-up. Tubular discectomy compared with conventional microdiscectomy resulted in a nonsignificant difference in CPK ratio, although the CSA ratio was significantly lower in tubular discectomy. At 1 year, there was no difference in atrophy grade between both groups nor in the percentage of patients showing an increased atrophy grade (14% tubular vs. 18% conventional). The postoperative low-back pain scores on the VAS improved in both groups, although the 1-year between-group mean difference of improvement was 3.5 mm (95% CI; 1.4-5.7 mm) in favour of conventional microdiscectomy. In conclusion, tubular discectomy compared with conventional microdiscectomy did not result in reduced muscle injury. Postoperative evaluation of CPK and the multifidus muscle showed similar results in both groups, although patients who underwent tubular discectomy reported more low-back pain during the first year after surgery.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.