Graduation of the Learning Curve from Small to Smaller: Evolution of Tubular Retractors from 18 mm to 14 mm in Management of Lumbar Disc Herniation
Objective While the utility of 16 mm and 18 mm diameter tubular-retractors in the management of prolapsed intervertebral-disc is well-established, there is no published literature on the use of 14 mm tube. The aim of this study is to retrospectively analyze the feasibility and outcomes of discectomy...
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| Format: | Article |
| Language: | English |
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Korean Minimally Invasive Spine Surgery Society
2019-06-01
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| Series: | Journal of Minimally Invasive Spine Surgery and Technique |
| Subjects: | |
| Online Access: | http://www.jmisst.org/upload/pdf/jmisst-2019-00010.pdf |
| _version_ | 1797951546069090304 |
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| author | Arvind Gopalrao Kulkarni Sagar Bhupendra Sharma Tushar Satish Kunder |
| author_facet | Arvind Gopalrao Kulkarni Sagar Bhupendra Sharma Tushar Satish Kunder |
| author_sort | Arvind Gopalrao Kulkarni |
| collection | DOAJ |
| description | Objective While the utility of 16 mm and 18 mm diameter tubular-retractors in the management of prolapsed intervertebral-disc is well-established, there is no published literature on the use of 14 mm tube. The aim of this study is to retrospectively analyze the feasibility and outcomes of discectomy performed through a 14 mm diameter tube in comparison with 16 mm and 18 mm diameter tubes. Methods Groups A, B and C consisting of the first 40 operated patients with symptomatic lumbar disc herniation using 18 mm, 16 mm and 14 mm tubes respectively between July-2007 and April-2018 were evaluated for VAS (leg pain) and ODI and followed up at 1 week, 6 weeks, 3 months, 6 months and 1-year intervals. Results The mean age in Groups A, B and C was 45.3 years (16-78), 47.15 years (20-78) and 42.15 years (17-65) respectively. The mean VAS in Group A, B and C improved from 7.89, 8.15 and 8.2 to 2.53, 2.4 and 2.34 respectively. The ODI in Groups A, B and C improved from 58.5, 56.4, 54.4 to 28.5, 25.6 and 22.4 respectively. The operative time and blood loss in Groups A, B and C were 106.9±44.9, 74±19.45 and 53.37±12.26 min and 54.75±21.11 mL, 47.5±11.03 mL and 43.75±6.86 mL respectively (p<0.0001). There were 8 complications in Group A, 4 in Group B and 2 in Group C. Conclusion In experienced hands there was a favourable trend with regards to operative feasibility, surgical time, surgical outcomes and complication rates with decreasing diameters of the tubular-retractor. |
| first_indexed | 2024-04-10T22:32:17Z |
| format | Article |
| id | doaj.art-c5d0488106094ffeb7f0c7d9686aa88b |
| institution | Directory Open Access Journal |
| issn | 2508-2043 |
| language | English |
| last_indexed | 2024-04-10T22:32:17Z |
| publishDate | 2019-06-01 |
| publisher | Korean Minimally Invasive Spine Surgery Society |
| record_format | Article |
| series | Journal of Minimally Invasive Spine Surgery and Technique |
| spelling | doaj.art-c5d0488106094ffeb7f0c7d9686aa88b2023-01-17T04:15:23ZengKorean Minimally Invasive Spine Surgery SocietyJournal of Minimally Invasive Spine Surgery and Technique2508-20432019-06-0141141810.21182/jmisst.2019.0001057Graduation of the Learning Curve from Small to Smaller: Evolution of Tubular Retractors from 18 mm to 14 mm in Management of Lumbar Disc HerniationArvind Gopalrao Kulkarni0Sagar Bhupendra Sharma1Tushar Satish Kunder2 Department of Orthopaedics, Mumbai Spine Scoliosis and Disc Replacement Centre, Bombay Hospital, Mumbai, India Department of Orthopaedics, Mumbai Spine Scoliosis and Disc Replacement Centre, Bombay Hospital, Mumbai, India Department of Orthopaedics, Mumbai Spine Scoliosis and Disc Replacement Centre, Bombay Hospital, Mumbai, IndiaObjective While the utility of 16 mm and 18 mm diameter tubular-retractors in the management of prolapsed intervertebral-disc is well-established, there is no published literature on the use of 14 mm tube. The aim of this study is to retrospectively analyze the feasibility and outcomes of discectomy performed through a 14 mm diameter tube in comparison with 16 mm and 18 mm diameter tubes. Methods Groups A, B and C consisting of the first 40 operated patients with symptomatic lumbar disc herniation using 18 mm, 16 mm and 14 mm tubes respectively between July-2007 and April-2018 were evaluated for VAS (leg pain) and ODI and followed up at 1 week, 6 weeks, 3 months, 6 months and 1-year intervals. Results The mean age in Groups A, B and C was 45.3 years (16-78), 47.15 years (20-78) and 42.15 years (17-65) respectively. The mean VAS in Group A, B and C improved from 7.89, 8.15 and 8.2 to 2.53, 2.4 and 2.34 respectively. The ODI in Groups A, B and C improved from 58.5, 56.4, 54.4 to 28.5, 25.6 and 22.4 respectively. The operative time and blood loss in Groups A, B and C were 106.9±44.9, 74±19.45 and 53.37±12.26 min and 54.75±21.11 mL, 47.5±11.03 mL and 43.75±6.86 mL respectively (p<0.0001). There were 8 complications in Group A, 4 in Group B and 2 in Group C. Conclusion In experienced hands there was a favourable trend with regards to operative feasibility, surgical time, surgical outcomes and complication rates with decreasing diameters of the tubular-retractor.http://www.jmisst.org/upload/pdf/jmisst-2019-00010.pdf14 mm tubular retractortubular micro-discectomymedlumbar disc herniationmicro-discectomymicro-endoscopic discectomy |
| spellingShingle | Arvind Gopalrao Kulkarni Sagar Bhupendra Sharma Tushar Satish Kunder Graduation of the Learning Curve from Small to Smaller: Evolution of Tubular Retractors from 18 mm to 14 mm in Management of Lumbar Disc Herniation Journal of Minimally Invasive Spine Surgery and Technique 14 mm tubular retractor tubular micro-discectomy med lumbar disc herniation micro-discectomy micro-endoscopic discectomy |
| title | Graduation of the Learning Curve from Small to Smaller: Evolution of Tubular Retractors from 18 mm to 14 mm in Management of Lumbar Disc Herniation |
| title_full | Graduation of the Learning Curve from Small to Smaller: Evolution of Tubular Retractors from 18 mm to 14 mm in Management of Lumbar Disc Herniation |
| title_fullStr | Graduation of the Learning Curve from Small to Smaller: Evolution of Tubular Retractors from 18 mm to 14 mm in Management of Lumbar Disc Herniation |
| title_full_unstemmed | Graduation of the Learning Curve from Small to Smaller: Evolution of Tubular Retractors from 18 mm to 14 mm in Management of Lumbar Disc Herniation |
| title_short | Graduation of the Learning Curve from Small to Smaller: Evolution of Tubular Retractors from 18 mm to 14 mm in Management of Lumbar Disc Herniation |
| title_sort | graduation of the learning curve from small to smaller evolution of tubular retractors from 18 mm to 14 mm in management of lumbar disc herniation |
| topic | 14 mm tubular retractor tubular micro-discectomy med lumbar disc herniation micro-discectomy micro-endoscopic discectomy |
| url | http://www.jmisst.org/upload/pdf/jmisst-2019-00010.pdf |
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