Open Access, Peer-reviewed
pISSN 2093-4378
eISSN 2093-4386
    J Korean Soc Spine Surg. 2008 Dec;15(4):265-271. Korean.
    Published online Dec 31, 2008.
    https://doi.org/10.4184/jkss.2008.15.4.265
    Copyright © 2008 Korean Society of Spine Surgery
    Original Article

    Lumbar Discectomy Using Tubular Retractor and Microendoscopy

    Sung Chan Ki, M.D., Yong Soo Choi, M.D., Ki Soo Kim, M.D. and Woo Jong Kuk, M.D.
      • Department of Orthopedic Surgery, Kwangju Christian Hospital, Gwangju, Korea.
    • Address reprint requests to: Yong Soo Choi, M.D. Department of Orthopaedic Surgery, Kwangju Christian Hospital, 264, Yangrim-dong, Nam-gu, Gwangju, Korea. Tel: 82-62-650-5064, Fax: 82-62-650-5066, Email: stemcellchoi@yahoo.co.kr

    Abstract

    Study Design

    Retrospective study

    Objectives

    To compare the surgical results of microendoscopic discectomy using a tubular retractor with those of a conventional discectomy for lumbar herniated nucleus pulposus.

    Summary of the Literature Review

    Minimally invasive approaches to the lumbar spine have been attempted with success over the past 25 years.

    Materials and Methods

    This study examined 36 cases who underwent lumbar discectomy using a tubular retractor and microendoscopy (Group A) and 30 cases who underwent a conventional discectomy (Group B). The operating time, intraoperative blood loss, postoperative hospital stay were recorded. The clinical results were assessed using the Korea Version Oswestry Disability Index (KODI), and the radiological results were evaluated from changes in disc height.

    Results

    The patients in Group A had a longer operation time(mean, 95.56±23.57 minutes vs 81.17±35.30 minutes, p=0.062), less intraoperative blood loss (mean, 58.61±97.08 cc vs 161.00±88.64 cc, p=0.001) and a shorter hospitalization stay (mean, 8.22±4.99 days vs 17.33±10.98 days, p=0.001) than group B. There was significant improvement in the mean KODI score for Group A; 6.36±7.18 and Group B; 5.97±5.14. However, there was no significant difference in the pain improvement (mean, 1.14±1.15 vs 1.30±1.06, p=0.559) and walking index (mean, 0.25±0.44 vs 0.30±0.47, p=0.656). In terms of social life, Group A had better results (mean, 0.20±0.48 vs 0.67±1.01, p=0.018). The disc height according to radiography decreased from 8.44±1.98 mm to 7.40±1.59 mm in Group A and 9.07±1.93 mm to 7.67±1.90 mm in Group B, but there were no statistical differences in the changes in disc height between the two groups (p=0.143).

    Conclusion

    Microendoscopic discectomy is an effective procedure with good outcomes in treating lumbar disc herniation that allows less tissue trauma, compared with conventional open discectomy.

    Keywords
    Microendoscopic; Conventional; Herniated nucleus pulposus; Microendoscopic discectomy

    Figures

    Fig. 1
    Endoscopic findings. (A) Laminotomy is done under tubular retractor and microendoscopy. (B) Endoscopic discectomy is doing.

    Fig. 2
    A 22 year-old woman with HNP L4-5. (A) Preoperative MRI shows herniated nucleus pulposus at L4-5. (B) Immediate postoperative computed tomographs shows hematoma compression at laminotomy area and spinal canal.

    Tables

    Table 1
    The results of operative procedures.

    Table 2
    Clinical and radiological results

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    MeSH Terms
    Diskectomy
    Hospitalization
    Humans
    Korea
    Length of Stay
    Postoperative Hemorrhage
    Retrospective Studies
    Spine
    Walking
    Metrics
    Share
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    Tables
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