Lumbar microdiscectomy and microendoscopic discectomy

Riesenburger, Ron I.; David, Carlos A.

doi:10.1080/13645700600958432

Cited by 42 publications

(30 citation statements)

References 13 publications

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“…Various studies have reported on outcomes of MD[2122] and TD[142324] and proved them to be better to open discectomy[213252627282930] but only few have compared outcomes of MD with TD. [3132]…”

Section: Discussionmentioning

confidence: 99%

Microdiscectomy or tubular discectomy: Is any of them a better option for management of lumbar disc prolapse

Bhatia

Chhabra

Mohapatra

et al. 2016

J Craniovert Jun Spine

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Objectives:Various types of minimally invasive techniques have been developed for the treatment of lumbar disc herniation. The original laminectomy was refined into microdiscectomy (MD). MD is the gold standard in management of lumbar disc herniation and is used as a yardstick for comparison with newer procedures such as tubular discectomy. So far, no studies have been reported in Indian population comparing tubular discectomy and microdiscectomy. The aim of this study was to compare immediate postoperative and 1-year outcome of patients undergoing tubular discectomy with those undergoing MD and to evaluate the learning curve as well as complication rates of tubular discectomy.Materials and Methods:Forty-six patients of MD and 102 (48 early and 54 late) patients of tubular discectomy (TD) were operated at Indian Spinal Injuries Centre, which is a tertiary level center between July 2009 and January 2012. They were studied for the following data: Baseline characteristics, visual analog scale (VAS) for leg pain and back pain, Oswestry Disability Index (ODI) scores, length of hospital stay, time taken to return to work, duration of surgery, intra- and post-operative complications, and reoperation rates.Results:The VAS score for leg pain, back pain, and ODI scores showed improvement in both groups during the 1st year after surgery. Time taken to return to work and mean hospital stay was shorter in case of TD as compared to MD group. The mean duration of surgery was 34 min shorter for conventional MD. The incidence of dural tear was 6.5% in MD group and 10.4% in early TD and decreased to 7.4% in late TD group.Conclusion:This study revealed that rate of recovery is significantly faster for TD as compared to conventional MD. In contrast, we encountered fewer complications in MD approach as compared to TD which although were not statistically significant and which also decreased as we gained experience.

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Section: Discussionmentioning

confidence: 99%

Microdiscectomy or tubular discectomy: Is any of them a better option for management of lumbar disc prolapse

Bhatia

Chhabra

Mohapatra

et al. 2016

J Craniovert Jun Spine

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“…Williams [31] proposed in 1978 a conservative microsurgical approach to virgin herniated lumbar discs by making only a blunt perforation in the fibrous annular ring without an incision or curettage of the disc space. This conventional microdiscectomy technique is considered to be the gold standard procedure for patients who require surgery for symptomatic lumbar disc herniation refractory to conservative measures [6,22,32]. Two of the main complications after lumbar discectomy are the recurrence of radicular pain and disc herniation.…”

Section: Introductionmentioning

confidence: 99%

Is Sequestrectomy a Viable Alternative to Microdiscectomy? A Systematic Review of the Literature

Fakouri

Shetty

White

2015

Clinical Orthopaedics &Amp; Related Research

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“…The herniated tissue with this technique is resected endoscopically using a small incision and a tubular retractor (16 or 18 mm in diameter). This microendoscopic discectomy (MED) has been known to cause less tissue damage than conventional open microdiscectomy procedures with a marked reduction in postoperative pain and muscle spasm, allowing the procedure to be performed in the outpatient setting, and enabling patients to return to their activities of daily living fast 6,15) . In addition, the MED group showed a lower incidence of persistent residual postoperative low back pain than the conventional microdiscectomy group one year after the operation 16) .…”

Section: Discussionmentioning

confidence: 99%

“…The microendoscopic discectomy (MED) was introduced by Foley and Smith 8) ; it was the first technique that addressed the shortcomings of the conventional subperiosteal approach. Many investigators have reported that MED is associated with less postoperative pain, a shorter hospital stay, and more rapid return to work 6,15) . However, the MED has some limitations related to a small operation field, visualized through a cylindrical tubular retractor 12) .…”

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Muscle Sparing Transmuscular Microdiscectomy : Technique and Comparison with Conventional Subperiosteal Microdiscectomy during the Early Postoperative Period

Park

Kwon

Won

et al. 2010

J Korean Neurosurg Soc

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Objective :The authors introduce a minimally invasive muscle sparing transmuscular microdiscectomy (MSTM) to treat herniated lumbar disc disease. Its results are compared with conventional subperiosteal microdiscectomy (CSM) to validate the effectiveness. Methods : Muscle sparing transmuscular microdiscectomy, which involves muscle dissection approach using the natural fat cleavage plane between the multifidus to expose the interlaminar space, was performed in 23 patients to treat a single level unilateral lumbar radiculopathy. The creatine phosphokinase (CPK)-MM serum levels were measured on admission and at 1, 3, and 5 days postoperatively. Postoperative pain was evaluated using a 10-point visual analogue scale (VAS) and recorded on admission and at 1, 3, and 5 days postoperatively. The results were compared to those from the conventional subperiosteal microdiscectomy (43 patients). Results : The CPK-MM levels were significantly lower in the serum of the MSTM group compared to the CSM group on postoperative days three and five (p = 0.03 and p = 0.02, respectively). The clinical scales for back pain using VAS were significantly lower in the MSTM group than in the CSM group on postoperative days three (p = 0.04). The mean VAS scores for leg pain in both groups showed no significant differences during the early postoperative period. Conclusion : Muscle sparing transmuscular microdiscectomy is a minimally invasive surgical option to treat lumbar radiculopathy due to herniated disc. The approach affected minimal injury to posterior lumbar supporting structures with alleviated postoperative back pain. KEY WORDS :Lumbar spine˙ Muscle sparing technique˙ Microdiscectomy˙ Minimally invasive surgery.

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Lumbar microdiscectomy and microendoscopic discectomy

Cited by 42 publications

References 13 publications

Microdiscectomy or tubular discectomy: Is any of them a better option for management of lumbar disc prolapse

Microdiscectomy or tubular discectomy: Is any of them a better option for management of lumbar disc prolapse

Is Sequestrectomy a Viable Alternative to Microdiscectomy? A Systematic Review of the Literature

Minimally Invasive Muscle Sparing Transmuscular Microdiscectomy : Technique and Comparison with Conventional Subperiosteal Microdiscectomy during the Early Postoperative Period

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