Minimally Invasive Muscle Sparing Transmuscular Microdiscectomy : Technique and Comparison with Conventional Subperiosteal Microdiscectomy during the Early Postoperative Period.
10.3340/jkns.2010.48.3.225
- Author:
Beom Seok PARK
1
;
Young Joon KWON
;
Yu Sam WON
;
Hyun Chul SHIN
Author Information
1. Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. neuriac@skku.edu
- Publication Type:Original Article
- Keywords:
Lumbar spine;
Muscle sparing technique;
Microdiscectomy;
Minimally invasive surgery
- MeSH:
Back Pain;
Creatine Kinase;
Humans;
Intervertebral Disc Degeneration;
Intervertebral Disc Displacement;
Leg;
Muscles;
Pain, Postoperative;
Postoperative Period;
Radiculopathy;
Weights and Measures
- From:Journal of Korean Neurosurgical Society
2010;48(3):225-229
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
