Microendoscopic discectomy for lumbar disc herniation - Surgical technique and outcome in 873 consecutive cases

Study Design. A retrospective review involving 873 consecutive cases of lumbar disc herniation treated by microendoscopic discectomy (MED) was conducted and a mean 28-month follow-up was performed. Objective. The purpose of this study was to describe the MED technique for lumbar disc herniation and report long-time outcome and complications. Summary of Background Data. The conception of MED was introduced in 1997. Long-time outcome has not been described. Method. A total of 873 consecutive patients with lumbar disc herniation were treated with the METRx system. Oswestry Disability Index (ODI) was used to quantify pain relief. The degree of pain and disability was also measured by visual analog scale (VAS) and modified MacNab criteria. A control group of 358 patients treated with standard open discectomy was used for comparison. Results. There was significant improvement in the mean preoperative and postoperative VAS and ODI score for the MED and open groups, and there was no statistical difference of the pain improvement between the two groups. For the MED group, average length of hospital stay was 4.8 days; mean time to return to work or normal activities was 15 days; average operative blood loss per level was 44 mL. These were significantly less than open group. Conclusions. MED is an effective microendoscopic system with fine long-term outcome in treating lumbar disc herniation. The endoscopic approach allows smaller incisions and less tissue trauma, compared with standard open microdiscectomy. Strict adherence to well-defined preoperative selection criteria could ensure optimal postoperative outcome.