Surgical treatment of lumbar intervertebral disc herniation by microendoscopic discectomy through posterior approach
- VernacularTitle:后路显微内窥镜手术治疗腰椎间盘突出症
- Author:
Hongle LU
;
Quanxi LIU
;
Xisheng WENG
- Publication Type:Journal Article
- Keywords:
Lumbar vertebrae;
Intervertebral disk displacement;
Surgical procedures, endoscopic
- From:
Chinese Journal of Orthopaedics
1999;0(04):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the indications, intraoperative problems and management of its complications of the microendoscopic discectomy (MED) in the treatment of lumbar intervertebral disc herni-ation through posterior approach. Methods 242 cases of lumbar disc herniation treated by MED were re-viewed retrospectively from March 2000 to March 2002. Of the 242 cases, there were 171 males and 71 fe-males aged from 19 to 71 years with an average of 34 years. Among them, the lesions were located at single level in 193, double levels in 46, and three levels in three. All of 242 patients were examined with CT, 48 of which were performed MR. Results 205 herniated discs of the single level were removed, 36 of the double levels, and one of the three levels. It was average 2.2 days for the patients to get off bed ranging from 24 hours to 6 days. Postoperative hospitalization was from 3 to 12 days with an average of 5.2 days. Among the intraoperative complications, dural tear happened in four, nerve root injury in two, and mistakes of localiza-tion in one. While in postoperative complications, there was discitis in one which happened at three weeks postoperatively, and was cured with antibiotics and ambulation for five months. All incision healed in one stage, except one suffered from superficial infection and healed by dress changing. All cases were followed up for 2 to 15 months with an average of 6 months. The average period for the patients retuning to daily life was 3.6 weeks, and 52.4% of the patients restored to previous work. According to Macnab's evaluation sys-tem for clinical outcomes, the results showed excellent in 183, good in 44, fair in 13 and poor in two, so the rate of excellent and good was 94%. However, there were two cases converted to open operation because of compressive neurological dysfunction. Conclusion Appropriate control of indications and skillful surgical technique are the key points to decrease the complication, and to improve the curative effect.
