Titre
Prévalence et facteurs de risque de delirium chez les patients COVID-19 positifs admis aux soins intensifs
Type
mémoire de master/maîtrise/licence
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Auteur(s)
Stauffacher, Sophie
Auteure/Auteur
Directrices/directeurs
Ben Hamouda, Nawfel
Directeur⸱rice
Liens vers les personnes
Liens vers les unités
Faculté
Université de Lausanne, Faculté de biologie et médecine
Statut éditorial
Accepté
Date de publication
2023-08-28
Nombre de pages
13
Langue
français
Résumé
Introduction
Non-inferiority of interlaminar full-endoscopic discectomy (ILFED) surgery for
lumbar disc hernia (LDH) regarding pain improvement and safety is well
established. However, current literature has not evaluated specifically the
outcome of LDH presenting with a motor weakness. We present the first study
comparing motor recovery with both techniques (microscopy versus ILFED) in a
single institution.
Methods
This retrospective monocentric case series, assessed surgical outcomes for
lumbar disc herniation with motor weakness between January 2020 and March
2023. Patients were divided into two groups : ILFED or microscopic
sequestrectomy. Motor recovery was assessed with Medical Research Council
scale (MRC) preoperatively, at discharge from the hospital, one and three months
after surgery. Demographics, opioid intake, length of stay and surgery duration
were retrieved.
Results:
159 patients were included. Both groups showed significant improvement at
discharge, one and three months after surgery compared to preoperatively
(p<0.000001). No significant differences between the groups were observed at
each follow-up. For secondary objectives, ILFED showed a significantly shorter
operating time (71.3 minutes ± 24.4) compared with the microscopy group (89.1
minutes ± 34.35, p=4.8e-6). Length of stay was also significantly shorter in
endoscopic group with 4.19 days ± SD 2.7 versus 6.94 ± SD 5.7 in microscopy
(p=1.511e-11). Opioid intake and work stoppage were not significantly different.
Conclusion
Interlaminar full-endoscopic discectomy (ILFED) seems to be an effective
procedure for improving motor weakness in lumbar disc hernia (LDH). In our
retrospective monocentric study, we did not find a statistically significant
difference when compared to standard microsurgical technique.
Non-inferiority of interlaminar full-endoscopic discectomy (ILFED) surgery for
lumbar disc hernia (LDH) regarding pain improvement and safety is well
established. However, current literature has not evaluated specifically the
outcome of LDH presenting with a motor weakness. We present the first study
comparing motor recovery with both techniques (microscopy versus ILFED) in a
single institution.
Methods
This retrospective monocentric case series, assessed surgical outcomes for
lumbar disc herniation with motor weakness between January 2020 and March
2023. Patients were divided into two groups : ILFED or microscopic
sequestrectomy. Motor recovery was assessed with Medical Research Council
scale (MRC) preoperatively, at discharge from the hospital, one and three months
after surgery. Demographics, opioid intake, length of stay and surgery duration
were retrieved.
Results:
159 patients were included. Both groups showed significant improvement at
discharge, one and three months after surgery compared to preoperatively
(p<0.000001). No significant differences between the groups were observed at
each follow-up. For secondary objectives, ILFED showed a significantly shorter
operating time (71.3 minutes ± 24.4) compared with the microscopy group (89.1
minutes ± 34.35, p=4.8e-6). Length of stay was also significantly shorter in
endoscopic group with 4.19 days ± SD 2.7 versus 6.94 ± SD 5.7 in microscopy
(p=1.511e-11). Opioid intake and work stoppage were not significantly different.
Conclusion
Interlaminar full-endoscopic discectomy (ILFED) seems to be an effective
procedure for improving motor weakness in lumbar disc hernia (LDH). In our
retrospective monocentric study, we did not find a statistically significant
difference when compared to standard microsurgical technique.
PID Serval
serval:BIB_217921990D59
Date de création
2023-08-29T07:27:52.489Z
Date de création dans IRIS
2025-05-20T13:59:24Z
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Nom
Mémoire no 10948 M. Stauffacher.pdf
Version du manuscrit
imprimatur
Taille
535.84 KB
Format
Adobe PDF
PID Serval
serval:BIB_217921990D59.P001
Somme de contrôle
(MD5):295b7f5cb9bacd8b38ebfc0581742f83