Objective To explore the emergent measures for hematomyelia during microendoscopic discectomy (MED). Methods Different measures, such as electrocoagulation, compression, irrigation, or hemostatic administration, were directed against different types of hematomyelia during MED. Results No conversions to open surgery for hematomyelia were required in all the 287 cases in the study. A follow-up for 4~30 months (mean, 17 months) was carried out. According to the MacNab criteria, excellent results were achieved in 219 cases, good results in 59 cases, fair in 7, and poor in 2. Conclusions Measures for hematomyelia during MED include the decrease of abdominal pressure, strict hemostatic performance, keeping off varicose veins when the protruded intervertebral disc is resected, compression by using gelfoam or styptic cotton, and intravenous administration of thrombin. These measures can effectively improve the surgical safety and the curative effect.

Objective To discuss surgical techniques during microendoscopic discectomy (MED) in the treatment of lumbar intervertebral disc herniation complicated with posterior longitudinal ligament calcification and osteophyte of posterior lumbar border. Methods The self-made arc-like annular knife and L-shape introducer were used during MED in the treatment of 115 patients. Results All the patients were followed for 12~30 months (mean, 22 months). According to the MacNab criteria, excellent or good results were achieved in 109 patients, fair results in 5 patients, and poor in 1, the rate of excellent or good results being 94.8% (109/115 ). No ruptured spinal dura mater, nerve root injuries, or infection of intervertebral space occurred. No conversions to open surgery were required. Conclusions Use of self-made instruments and corresponding modified techniques during MED can effectively manage the problems of posterior longitudinal ligament calcification and osteophyte of posterior lumbar border, which broadens the surgical indication and improves the efficacy and safety.