Comparative Evaluation of Percutaneous Endoscopic Discectomy and Microdiscectomy Using Tubular Retractor System at L4-5 Level (제 4-5 요추간 추간판 탈출증에 시행된 최소 침습적 두 술식의 비교: 경피적 내시경하 추간판 절제술과 통형 견인기하 추간판 절제술)

JangEuiChan (장의찬); 강기서; Kim Jae Yoon (김재윤); 양재준; 고영봉; Kwang-Sup Song (송광섭); 김기성

Comparative Evaluation of Percutaneous Endoscopic Discectomy and Microdiscectomy Using Tubular Retractor System at L4-5 Level

Journal of Korean Society of Spine Surgery
Abbr : J Kor Spine Sur
2009, 16(3), pp.186-193
Publisher : Korean Society Of Spine Surgery
Research Area : Medicine and Pharmacy > Orthopedic Surgery

JangEuiChan ¹, 강기서 ¹, Kim Jae Yoon ¹, 양재준 ¹, 고영봉 ¹, Kwang-Sup Song ¹, 김기성 ²

¹중앙대학교
²진천 성모병원

Candidate

ABSTRACT

Study Design: A prospective, non-randomized study Objectives: To evaluate the early clinical results of percutaneous endoscopic lumbar discectomy (PELD) and microdiscectomy (MD) using a tubular retractor. Summary of the Literature Review: There are few reports comparing the clinical results of different minimal invasive surgical procedures for disc herniation. Materials and Methods: Out of 41 patients who underwent a discectomy at the L4-5 level, 16 patients (Group Ⅰ) underwent PELD and 25 patients (Group Ⅱ) underwent MD. The surgical techniques were based on the patient’s selection. The characteristics of the operation(operation time, time for C-arm, amount of removed disc) were compared with the clinical outcomes by evaluating the SLR (straight leg raising test), leg VAS (visual analogue scale), ODI (Oswestry Disability Index), hospital day, changes in disc height. Results: Group I showed a larger amount of disc removed and exposure time for the C-arm than group Ⅱ (p<0.05). However, the hospital day was shorter in group I than in group Ⅱ (p<0.05). There were no differences in the leg VAS, ODI, the change in disc height and surgery time between the two groups at the last follow up. One case in group I had a neuropraxia of the L5 root that had recovered fully at postoperative 3months. In group Ⅱ, there was one case of a postoperative hematoma and 2 cases of a dural tear. Conclusion: Although the early clinical outcomes were similar in both groups, group Ⅰ showed a larger amount of disc removed and more exposure time to radiation but a shorter hospital stay.

KEYWORDS

Lumbar disc herniation, Ppercutaneous endoscopic lumbar discectomy, Microdiscectomy, Minimally invasive surgery

Citation status

* References for papers published after 2023 are currently being built.

[journal] Davis H / 1994 / Increasing rates of cervical and lumbar spine surgery in the United States, 1979-1990 / Spine 19 : 1117~1123

[journal] Dandy WE / 1989 / Loose cartilage from intervertebral disk simulating tumor of the spinal cord. By Walter E. Dandy, 1929 / Clin Orthop Relat Res 238 : 4~8

[journal] Kambin P / 1987 / Percutaneous posterolateral discectomy. Anatomy and mechanism / Clin Orthop Relat Res 223 : 145~154

[journal] Maroon JC / 1999 / Association between peridural scar and persistent low back pain after lumbar discectomy / Neurol Res 21 : 43~46

[journal] Smith L / 1964 / Enzyme dissolution of the nucleus pulposus in humans / JAMA 187 : 137~140

[journal] Hijikata S / 1989 / Percutaneous nucleotomy : A new concept technique and 12 years experience / Clin Orthop Relat Res 238 : 9~23

[journal] Smith MM / 1997 / Microendoscopic discectomy system : surgical technique and initial clinical results / Tech Neurosurg 3 : 301~307

[journal] Xiaotao W / 2006 / Microendoscopic discectomy for lumbar disc herniation: Surgical technique and outcome in 873 consecutive cases / Spine 31 : 2689~2694

[journal] Anthony T / 2007 / Minimally invasive techniques for the management of lumbar disc herniation / Orthop Clin N Am 38 : 363~372

[journal] Casper GD / 1996 / Laser assisted disc decompression: an alternative treatment modality in the Medicare population / J Okla State Med Assoc 89 : 11~15

[journal] Hermantin FU / 1999 / A prospective, randomized study comparing the results of open discectomy with those of video-assisted arthroscopic microdiscectomy / J Bone Joint Surg Am 81 : 958~965

[journal] Mochida J / 1994 / Appropriate procedures of posterior herniotomy and percutaneous nucletomy in lumbar disc herniation / Rinsho Seikei Geka 29 : 423~430

[journal] Yeung AT / 2002 / Posterolateral endoscopic excision for lumbar disc herniation: Surgical technique, outcome, and complications in 307 consecutive cases / Spine 27 : 722~731

[journal] Chung JY / 2007 / Percutaneous endoscopic discectomy for lumbar disc herniation / J Korean Soc Spine Surg 14 : 212~219

[journal] Kang YH / 2000 / Comparison of the results between standard discectomy and microdiscectomy of the herniated lumbar disc / J Korean Soc Spine Surg 7 : 228~233

[journal] Matsui H / 1995 / Physiologicchanges of nerve root during posterior lumbar discectomy / Spine 20 : 654~659

[journal] Hijikata S / 1975 / Percutaneous discectomy : A new treatment method for lumbar disc herniation / J Toden Hosp 5 : 5~13

[journal] Onik G / 1985 / Percutaneous lumbar discectomy using a new aspiration probe / AJNR 6 : 1137~1140

[journal] Onik G / 1990 / Automated percutaneous biopsy in postoperative diskitis: a new method / AJNR 11 : 391~393

[journal] Nakagawa H / 2003 / Miyasaka T: Microendoscopic discectomy (MED) for lumbar disc prolapsed / J Clin Neurosci 10 : 231~235

[journal] Kambin P / 1986 / Posterolateral percutaneous suction- excision of herniated lumbar intervertebral discs. Report of interim results / Clin Orthop Relat Res 207 : 37~43

[journal] Kikuchi S / 1986 / Anatomic features of the furcal nerve and its clinical significance / Spine 11 : 1002~1007

[journal] Schick U / 2002 / Microendoscopic lumbar discectomy versus open surgery: an intraoperative EMG study / Eur spine J 11 : 20~26

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