Microendoscopic lumbar discectomy: technical note.

Abstract:

OBJECTIVE:The microendoscopic discectomy (MED) technique was initially developed in 1997 to treat herniated lumbar disc disease. Since then, thousands of cases have been successfully performed at more than 500 institutions. This article discusses the technical aspects of this procedure and presents a consecutive case series. METHODS:A total of 150 consecutive patients underwent MED. MED is performed by a muscle-splitting approach using a series of tubular dilators with consecutively increasing diameters. A tubular retractor is then inserted over the final dilator, and a specially designed endoscope is placed inside the tubular retractor. The microdiscectomy is performed endoscopically while the surgeon views the procedure on a video monitor. RESULTS:Clinical outcomes were determined using a modified MacNab criteria, which revealed that 77% of patients had excellent, 17% had good, 3% had fair, and 3% had poor outcomes. The average hospital stay was 7.7 hours. The average return to work period was 17 days. Complications primarily included dural tears, which occurred in 8 patients (5%) and were seen early on in the patient series. Complication rates diminished as the surgeon's experience with this technique increased. CONCLUSION:MED for lumbar herniated disc disease can be performed safely and effectively, resulting in a shortened hospital stay and faster return to work; however, there is a learning curve to this procedure.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Perez-Cruet MJ,Foley KT,Isaacs RE,Rice-Wyllie L,Wellington R,Smith MM,Fessler RG

keywords:

subject

Has Abstract

pub_date

2002-11-01 00:00:00

pages

S129-36

issue

5 Suppl

eissn

0148-396X

issn

1524-4040

journal_volume

51

pub_type

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