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KMID : 1148120190090010001
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Journal of Advanced Spine Surgery
2019 Volume.9 No. 1 p.1 ~ p.6
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Tubular Microdiscectomy for the Treatment of Herniated Lumbar Disc
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Lee Soo-Bin
Kwon Ji-Won
Kim Sang-Hee
Ha Joong-Won
Park Yung
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Abstract
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Study Design: A retrospective case series.
Purpose: To evaluate and analyze the clinical results of lumbar microdiscectomy using minimally invasive tubular retractor between recurrence and non-recurrence group, and to assess the merits of minimally invasive spinal surgery.
Overview of Literature: No large registry study has so far investigated the clinical results of lumbar microdiscectomy using minimally invasive tubular retractor.
Methods: From July 2003 to April 2011 we retrospectively studied a consecutive series of 156 patients who underwent lumbar microdiscectomy using minimally invasive tubular retractor. The following data were collected: clinical outcomes, operative time, intraoperative blood loss, recurrence, and complications. The clinical outcomes were measured using a visual analog scale (VAS) and assessed by the modified MacNab criteria.
Results: Minimally invasive tubular microdiscectomy was performed in 156 patients. The clinical outcomes assessed by MacNab criteria were excellent in 63 patients (40%), good in 71 patients (45%). VAS scores of low-back pain decreased from a mean of 6.7 prior to surgery to 2.5 after surgery, and that of leg pain decreased from 7.2 to 2.1. The average operative time was 68 minutes (range, 25 to 180 minutes). The average blood loss was 42 mL (range, 0 to 500 mL). None of the patients needed blood replacement. One patient had wound infection problem but there was no dural tear case. Twenty-two patients had recurrence. Average time to recurrence was about 42 months. Seventeen cases recurred at the same level and five cases recurred at the adjacent level. Eleven cases in 22 patients with recurrence were contained disc type and the others were non-contained disc type. Eighteen cases in 22 patients with recurrence were paracentral disc herniation type and the others were far lateral type. Average body mass index (BMI) of recurrence cases was 24.7 (range, 17.5 to 31.3) and that of non-recurrence cases was 24.5 (range, 16.3 to 39.2).
Conclusions: Lumbar microdiscectomy using tubular retractor can offer a useful modality for the treatment of lumbar herniated disc with the merits of minimally invasive spinal surgery. Further randomized, prospective investigations are needed to fully evaluate the impact of this technique.
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KEYWORD
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Minimally invasive, Lumbar microdiscectomy, Tubular retractor, Herniated lumbar disc
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