Quality of life and clinical outcome of post-micro endoscopic discectomy in lumbar disc disease at Soebandi General Hospital

Authors

  • I Nyoman Semita Orthopaedic Department, Faculty of Medicine, Jember University, Soebandi General Hospital, Jember, Indonesia

DOI:

https://doi.org/10.31282/joti.v2n2.38

Keywords:

Lumbar disc disease, Micro endoscopic discectomy, minimally invasive spine surgery

Abstract

Introduction: 

Open surgery can cause many complications. Currently, micro endoscopic discectomy (MED) is providing effective treatment, less muscle and local damage, better cosmetics, decreased pain and operative time, and faster recovery after surgery. We report quality of life and clinical outcome of lumbar disc disease post- MED.
 
Methods:

 45 consecutive patients underwent MED. The patients were observed for 12-24 months. The results were evaluated by using VAS and Macnab criteria. All patients were operated by a single spine surgeon with the METRxTM system (Medtronics Sofamor-Danek, Memphis, TN, USA).
 
Results: 

The quality of life of most patients improved to good to excellence with 94.4% patients return to work post-MED. Clinical outcome by Macnab criteria post-MED for the patients showed excellence (83,3%), good (11,1%), fair (2,8%), and poor (2,8%). Evaluation of back pain and leg pain were performed with VAS. VAS scale showed no pain (88,9%), back pain (8,3%), and leg pain (2,8%). The average of time of operation were 57 minutes, but stenosis needed longer operative time. Hospital length stay was less than 2 days, but older patients needed longer. Blood loss less than 50cc. With this technique, we didn’t get neurological injuries but we got one discitis and dural tear, this complication was immediately overcome by open surgery.
 
Conclusion: 

The MED technique is a feasible and efficacious, minimally invasive, approach for lumbar disc disease without instability.
 

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References

Xinyu L, Suomao Y, Yonghao T, Lianlei W, Liangtai G, Yanping Z, Jianmin L. Comparison of percutaneous endoscopic transforaminal discectomy, microendoscopic discectomy, and microdiscectomy for symptomatic lumbar disc herniation: minimum 2-year follow-up results. J Neurosurg Spine. 2018.

Arvind G K, Anupreet B, Abhilash D. Microendoscopic lumbar discectomy: Technique and results of 188 cases. Indian Journal of Orthopaedics. 2014; 48(1).

Shun L, Xiang W, Zhong WJ, Bin R, Quan W, Wen Bo D, Yun F. Percutaneous Transforaminal Endoscopic Discectomy for Lumbar Disc Herniation: A Retrospective Study. Annals of Clinical and Laboratory Research. 2019; 79(1):291.

Arvind G K, Anupreet B, Abhilash D. Microendoscopic lumbar discectomy: Technique and results of 188 cases. Indian Journal of Orthopaedics. 2014; 48(1).

Nakagawa H, Kamimura M, Uchiyama S, Takahara K, Itsubo T, Miyasaka T. Microendoscopic discectomy (MED) for lumbar disc prolapse. J Clin Neurosci 2003;10:231‑5.

Caspar W, Campbell B, Barbier DD, Kretschmmer R, Gotfried Y. The Caspar microsurgical discectomy and comparison with a conventional standard lumbar disc procedure. Neurosurgery. 1991;28:78‑87.

Foley KT, Smith MM. Micro endoscopic discectomy. Techniques in. Neurosurgery. 1997;3:301‑7.

Mick JPC, Kevin TF, Robert EI, Lauri RW, Robin WS, Richard GF. Microendoscopic Lumbar Discectomy: Technical Note. Neurosurgery. 2002. 51(Suppl 2):129–136.

Giulio A, Alessandro L, Federico C, André BF, Christian B, Roberto D, Emiliano P. Lumbar Endoscopic Microdiscectomy: Where Are We Now? An Updated Literature Review Focused on Clinical Outcome, Complications, and Rate of Recurrence. BioMed Research International. 2015.

Alok R, Rahul L. Microendoscopic discectomy for prolapsed lumbar intervertebral disc. Neurology India. 2006; 54(2).

Shun L, Xiang W, Zhong WJ, Bin R, Quan W, Wen Bo D, Yun F. Percutaneous Transforaminal Endoscopic Discectomy for Lumbar Disc Herniation: A Retrospective Study. Annals of Clinical and Laboratory Research. 2019; 79(1):291.

Xinyu L, Suomao Y, Yonghao T, Lianlei W, Liangtai G, Yanping Z, Jianmin L. Comparison of percutaneous endoscopic transforaminal discectomy, microendoscopic discectomy, and microdiscectomy for symptomatic lumbar disc herniation: minimum 2-year follow-up results. J Neurosurg Spine. 2018.

Garg B, Nagraja UB, Jayaswal A: Microendoscopic versus open discectomy for lumbar disc herniation: a prospective randomized study. J Orthop Surg (Hong Kong) 19:30–34, 2011.

Teli M, Lovi A, Brayda-Bruno M, Zagra A, Corriero A, Giudici F, et al: Higher risk of dural tears and recurrent herniation with lumbar micro-endoscopic discectomy. Eur Spine J 19:443–450, 2010

Zihao C, Liangming Z, Jianwen D, Peigen X, Bin L, Qiyou W. Percutaneous transforaminal endoscopic discectomy compared with microendoscopic discectomy for lumbar disc herniation: 1-year results of an ongoing randomized controlled trial.

Wu X, Zhuang S, Mao Z, et al. Micro endoscopic Discectomy for Lumbar Disc Herniation: Surgical Technique and Outcome in 873 Consecutive Cases. Spine (Phila Pa 1976). 2006; 31: 2689-94.

Destandau J. Endoscopic Lumbar Disc Surgery: A Study of 1562 cases. Internet Journal of Minimally Invasive Surgical Technology 2008;2:16.

Marappan K, Jothi R, Raj SP. Micro endoscopic discectomy (MED) for Lumbar Disc Herniation: Comparison of Learning Curve of the Surgery and Outcome with Other Established Case Studies. Journal of Spine Surgery. 2018; 4(3): 630-637.

Nakagawa Y, Yoshida M, Maia K. Micro endoscopic Discectomy (MED) For Surgical Management Of Lumbar Disc Disease: Technical Note. The Internet Journal of Spine Surgery 2005;2:1-7

Zhang C, Zhou Y, Chu TW, et al. Traumatic responses following microendoscopic discectomy: clinical analysis of 44 patients. Zhonghua Yi Xue Za Zhi 2006;86:3039-42.

Sasaoka R, Nakamura H, Konishi S, et al. Objective assessment of reduced invasiveness in MED. Compared with conventional one-level laminotomy. Eur Spine J 2006;15:577-82.

Chao Z, Yue Z, Tong-Wei C, et al. Microendoscopic discectomy, a less traumatic procedure for lumbar disk herniation. Chin J Traumatol 2007;10:311-4.

Huang TJ, Hsu RW, Li YY, et al. Less systemic cytokine response in patients following microendoscopic versus open lumbar discectomy. J Orthop Res 2005;23:406-11.

Schick U, Döhnert J, Richter A, et al. Microendoscopic lumbar discectomy versus open surgery: an intraoperative EMG study. Eur Spine J 2002;11:20-6.

Sasani M, Ozer AF, Oktenoglu T, et al. Percutaneous endoscopic discectomy for far lateral lumbar disc herniations: prospective study and outcome of 66 patients. Minim Invasive Neurosurg 2007;50:91-7.

Le H, Sandhu FA, Fessler RG. Clinical outcomes after minimal-access surgery for recurrent lumbar disc herniation. Neurosurg Focus 2003;15: E12.

Isaacs RE, Podichetty V, Fessler RG. Micro endoscopic discectomy for recurrent disc herniations. Neurosurg Focus 2003;15: E11.

Additional Files

Published

2019-08-25