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Do not draw blood samples more than twice weekly on the inpatient ward unless strictly indicated.
Choosing Wisely Netherlands Campaign
Dutch Association of Internal Medicine -Dutch OMS Association - ZonMw
Not drawing blood samples more frequent than necessary, is patient-friendly without compromising the quality and safety of the treatment. Less diagnostics tests are considerably cheaper
For further information please visit the website of the initiative (link below)
In lumbosacral radicular syndrome based on a herniated lumbar disc, only apply new surgical techniques for herniated lumbar discs in randomized clinical trials.
Choosing Wisely Netherlands Campaign
Dutch Society of Neurosurgery - Dutch OMS Association - ZonMw
Surgical techniques for operating on a lumbar herniated disc are in constant development.
A new technique, however, should not be applied until it has been confirmed to be safe and
effective.
For further information please visit the website of the initiative (link below)
In lumbosacral radicular syndrome based on a herniated lumbar disc, do not operate if the pain dermatome does not correspond to the compressed nerveroot.
Choosing Wisely Netherlands Campaign
Dutch Society of Neurosurgery - Dutch OMS Association - ZonMw
Compression of a nerve root can only cause pain in the specified area served by that nerve
in a part of the skin (known as the dermatome). However, pain sometimes radiates to a completely
different area of the limb not corresponding to level and site of MRI findings. In that
case, an operation will not resolve the pain, but identifying the cause of the pain advanced
diagnostic is recommended.
For further information please visit the website of the initiative (link below)
In lumbosacral radicular syndrome based on a herniated lumbar disc, do not request routine MRI of the lumbar spine during natural recovery or after disc surgery.
Choosing Wisely Netherlands Campaign
Dutch Society of Neurosurgery - Dutch OMS Association - ZonMw
Most patients with a lumbar hernia (90%) are symptom-free again within 6-18 weeks. If a
herniated lumbar disc is suspected based on sciatic leg pain, there is no point in doing an
MRI scan at this stage.
For further information please visit the website of the initiative (link below)
In lumbosacral radicular syndrome based on a herniated lumbar disc, do not operate if leg pain is brief (<6 weeks), but do not wait too long either (>6 months).
Choosing Wisely Netherlands Campaign
Dutch Society of Neurosurgery - Dutch OMS Association - ZonMw
Research does show that lumbar herniated dis surgery achieves the optimal results if surgery takes place between 3 and 6 months after the start of leg pain symptoms. In nearly all cases, pain caused by a herniated disc resolves by itself within 6 to 18 weeks. If a patient and his/her doctor waits too long to decide for surgery in case of severe nerve pain in a leg, the results of the operation are often less optimal. This is probably due to neural damage by chronic compression of the nerve by a ...
ver más ... 2014