본 연구는 자가간호프로그램이 요추간판제거술 환자의 운동이행 자기효능감, 자가간호지식, 자가간호이행에 미치는 효과를 확인하기 위한 실험연구이다. 대상자는 D광역시 소재 일개 척추전문병원 입원환자 중 미세현미경 요추간판제거술을 받은 환자로 실험군 26명, 대조군 27명이다. 수집된 자료는 SPSS 25프로그램을 이용하여 평균, 백분율, 표준편차, t-test, χ2-test, t-test, repeated measures ANOVA로 분석하였다. 연구결과 자가간호프로그램 중재를 받은 실험군은 제공받지 않은 대조군에 비해 시간이 경과함에 따라 보조기 관리지식(p=.001)과 일상생활관리지식점수(p=.005)가 더 높아 지지되었다. 또한 자가간호 프로그램을 제공받은 실험군은 제공받지 않는 대조군보다 보조기 관리이행도(p=.011), 일상생활 이행도 (p=.007), 유해생활 습관관리 이행도(p=.011)가 높아 지지되었다. 따라서 자가간호프로그램은 요추간판제 거술 환자의 수술 전후 적용을 통해 운동이행 자기효능감, 자가간호지식 및 자가간호이행도를 향상시켜 보다 빠른 회복을 도울 수 있는 프로그램이라고 할 수 있다.

Percutaneous endoscopic lumbar discectomy is getting popular technique as an alternative to conventional discectomy. This endoscopic surgery have many advantages such as less injury to muscle and soft tissue, less postoperative pain, and shorter operation time without general anesthesia and shortened hospitalization. We performed retrospective controlled randomized study from January 2008 to April 2015. Total 250 patients were treated by surgery (open microdiscectomy and endoscopic discectomy) during eight years. Age, sex, and operation level were not statistically significant difference about recurrent rate. Likewise, operation technique such as endoscopic discectomy or open discectomy were not statistically significant difference for recurrent rate.

The lumbar discectomy is the surgery with low morbidity itself and need the prone position, which is essential for this surgery. However, the increased intra-abdominal pressure after changing supine to prone position may lead intra-abdominal hypertension or abdominal compartment syndrome, consequently acute mesenteric ischemia. Acute mesenteric ischemia is one of the fatal conditions of acute abdomen with overall mortality of 60% to 100%. Unfortunately, the early detection of mesenteric ischemia in perioperative period of spinal surgery is difficult. We herein report an experience of acute mesenteric ischemia after lumbar discectomy in prone position, and review the relative literatures.

After percutaneous endoscopic lumbar discectomy (PELD), postoperative radiating leg pain could persist and become a common problem. This symptom provides important information for use in deciding on performance of reoperation for remnant disc or recurrent disc herniation. Of 225 patients who underwent PELD, 51 patients had persistent radicular pain. Steroid injection to epidural space resulted in pain reduction of at least 50 % in 15 (30.3 %) of these patients. Thirty five cases showed a bad outcome after steroid injection, indicating high sensitivity for detection of a remnant or disc herniation in follow up Magnetic Resonance images (25 cases, 71.4%). Twenty one patients were treated by reoperation. Steroid injection has a diagnostic value with a high sensitivity for mechanical compression of the nerve root as remaining or recurrent disc herniation in MRI for the necessity of a re-operation.