|Abstract / Summary|
About the PhD thesis
Lumbar disc herniation is one of the most common back disorders. It most often affects people aged 20-40 years and can lead to long- term sick leave. Surgery to remove the prolapse is an effective treat- ment for lack of symptom improvement after 6-12 weeks. It provides relief from pain and provides a faster return to work. Despite good re- sults, there is a relatively high proportion who needs resurgery, most often due to reherniation.
The PhD dissertation is based on three studies: 1) a biomechanical test of an experimental method for repairing the outer ring of the disc, 2) a clinical trial that examined a novel implant for use in conjunction with discectomy, 3) a systematic review of the literature as well as network meta-analysis, to compare all current surgical methods and conservative treatment.
The project found that the experimental method had a beneficial bio- mechanical profile, unfortunately the repair was not effective enough to prevent reherniation. In the clinical trial, the implant tested proved to be equally safe as standard discectomy. Due to the size of the trial, it was not possible to measure a difference in efficiency. In the systematic review of the literature, 32 studies were identified, which compared 8 treatments. The quality of the studies was variable. The network meta-analysis showed that conservative treatment as well as percutaneous discectomy performed worse than the usual surgical treatments.
The dissertation concludes that surgery for disc herniation is still indi- cated if there is the lack of effect of conservative treatment. The ex- perimental and new methods studied gave promising results, but it was not possible to show that they were better than the current treat- ment.