Microendoscopic discectomy for lumbar disc herniations
Introduction: Lumbar disc herniation is one of the main causes of discogenic low back pain and reported to affect 60%–80% of people during their lifetime. The two main surgical modalities for intervertebral disc surgery are standard open discectomy and minimally invasive discectomy which include per...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2018-01-01
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| Series: | Journal of Craniovertebral Junction and Spine |
| Subjects: | |
| Online Access: | http://www.jcvjs.com/article.asp?issn=0974-8237;year=2018;volume=9;issue=3;spage=156;epage=162;aulast=Patil |
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| author | Anil Patil Ashish Chugh Sarang Gotecha Megha Kotecha Prashant Punia Aditya Ashok Gaurav Amle |
| author_facet | Anil Patil Ashish Chugh Sarang Gotecha Megha Kotecha Prashant Punia Aditya Ashok Gaurav Amle |
| author_sort | Anil Patil |
| collection | DOAJ |
| description | Introduction: Lumbar disc herniation is one of the main causes of discogenic low back pain and reported to affect 60%–80% of people during their lifetime. The two main surgical modalities for intervertebral disc surgery are standard open discectomy and minimally invasive discectomy which include percutaneous endoscopic lumbar discectomy and microendoscopic discectomy (MED). We report our experience with the same technique of MED to evaluate the efficacy of MED for lumbar disc pathology.
Aims and Objectives: The aims and objectives were to study the efficacy, advantages, and associated limitations and complications of MED in lumbar disc herniations.
Materials and Methods: This study was carried out on 300 patients who had single-level herniated disc. The procedure was done by Microscopic Endoscopic Tubular Retraction System. Preoperative assessment of Visual Analog Scale (VAS) and modified Suezawa and Schreiber (MSS) clinical scoring system was documented 1 day prior to surgery. Postoperative results were determined to be excellent, good, fair, or poor according to MacNab criteria and also evaluated by MSS clinical scoring system on postoperative day 7 and after 6 months.
Results: A total of 187 patients were males and 113 patients were females and a majority of patients were in the age group of 31–40 years. A total of 192 patients had disc herniations at L4–L5 level. The mean operative time was 82 min and the mean hospital stay was 5.3 days. Eighteen cases (6%) developed postoperative complications including discitis, dysesthesia, recurrent prolapsed intervertebral disc, residual disc, dural tear, and nerve root injury. Mean preoperative VAS score was 8.7 and the mean postoperative VAS scores at postoperative day 7 and at 6 months were 2.25 and 1.12, respectively. The mean preoperative MSS score was 3.27 and the MSS scores at postoperative day 7 and at 6 months were 7.42 and 8.2, respectively. The overall successful outcome of the endoscopic discectomy after 6-month follow-up on the basis of VAS improvement percentage was 87.6%, MSS scoring percentage was 91.6%, and MacNab scoring percentage was 92.67%.
Conclusion: MED is a safe and effective technique. It offers decreased blood loss, shorter operative time, shorter in-hospital stay, decreased need for pain medication, decreased rate of infection, and a shorter return to work time. Limitations of this technique include a learning curve which is related to surgery time, complications, conversion to open procedures, and recurrent disc herniation. |
| first_indexed | 2024-12-23T10:46:18Z |
| format | Article |
| id | doaj.art-83f418f281404008b9316fb3f9244744 |
| institution | Directory Open Access Journal |
| issn | 0974-8237 |
| language | English |
| last_indexed | 2024-12-23T10:46:18Z |
| publishDate | 2018-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Craniovertebral Junction and Spine |
| spelling | doaj.art-83f418f281404008b9316fb3f92447442022-12-21T17:50:01ZengWolters Kluwer Medknow PublicationsJournal of Craniovertebral Junction and Spine0974-82372018-01-019315616210.4103/jcvjs.JCVJS_61_18Microendoscopic discectomy for lumbar disc herniationsAnil PatilAshish ChughSarang GotechaMegha KotechaPrashant PuniaAditya AshokGaurav AmleIntroduction: Lumbar disc herniation is one of the main causes of discogenic low back pain and reported to affect 60%–80% of people during their lifetime. The two main surgical modalities for intervertebral disc surgery are standard open discectomy and minimally invasive discectomy which include percutaneous endoscopic lumbar discectomy and microendoscopic discectomy (MED). We report our experience with the same technique of MED to evaluate the efficacy of MED for lumbar disc pathology. Aims and Objectives: The aims and objectives were to study the efficacy, advantages, and associated limitations and complications of MED in lumbar disc herniations. Materials and Methods: This study was carried out on 300 patients who had single-level herniated disc. The procedure was done by Microscopic Endoscopic Tubular Retraction System. Preoperative assessment of Visual Analog Scale (VAS) and modified Suezawa and Schreiber (MSS) clinical scoring system was documented 1 day prior to surgery. Postoperative results were determined to be excellent, good, fair, or poor according to MacNab criteria and also evaluated by MSS clinical scoring system on postoperative day 7 and after 6 months. Results: A total of 187 patients were males and 113 patients were females and a majority of patients were in the age group of 31–40 years. A total of 192 patients had disc herniations at L4–L5 level. The mean operative time was 82 min and the mean hospital stay was 5.3 days. Eighteen cases (6%) developed postoperative complications including discitis, dysesthesia, recurrent prolapsed intervertebral disc, residual disc, dural tear, and nerve root injury. Mean preoperative VAS score was 8.7 and the mean postoperative VAS scores at postoperative day 7 and at 6 months were 2.25 and 1.12, respectively. The mean preoperative MSS score was 3.27 and the MSS scores at postoperative day 7 and at 6 months were 7.42 and 8.2, respectively. The overall successful outcome of the endoscopic discectomy after 6-month follow-up on the basis of VAS improvement percentage was 87.6%, MSS scoring percentage was 91.6%, and MacNab scoring percentage was 92.67%. Conclusion: MED is a safe and effective technique. It offers decreased blood loss, shorter operative time, shorter in-hospital stay, decreased need for pain medication, decreased rate of infection, and a shorter return to work time. Limitations of this technique include a learning curve which is related to surgery time, complications, conversion to open procedures, and recurrent disc herniation.http://www.jcvjs.com/article.asp?issn=0974-8237;year=2018;volume=9;issue=3;spage=156;epage=162;aulast=PatilLumbar disc herniationminimally invasive spine surgerymicroendoscopic discectomy |
| spellingShingle | Anil Patil Ashish Chugh Sarang Gotecha Megha Kotecha Prashant Punia Aditya Ashok Gaurav Amle Microendoscopic discectomy for lumbar disc herniations Journal of Craniovertebral Junction and Spine Lumbar disc herniation minimally invasive spine surgery microendoscopic discectomy |
| title | Microendoscopic discectomy for lumbar disc herniations |
| title_full | Microendoscopic discectomy for lumbar disc herniations |
| title_fullStr | Microendoscopic discectomy for lumbar disc herniations |
| title_full_unstemmed | Microendoscopic discectomy for lumbar disc herniations |
| title_short | Microendoscopic discectomy for lumbar disc herniations |
| title_sort | microendoscopic discectomy for lumbar disc herniations |
| topic | Lumbar disc herniation minimally invasive spine surgery microendoscopic discectomy |
| url | http://www.jcvjs.com/article.asp?issn=0974-8237;year=2018;volume=9;issue=3;spage=156;epage=162;aulast=Patil |
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