Three-year Follow-Up Results of Lumbar Microendoscopic Discectomy (MED): A Prospective Study in 150 Patients

Background Data: The goal of all described surgical techniques to treat lumbar disc prolapse is removing the offending disc material, decompressing the nerve root, and relieving neurologic symptoms while avoiding complications. The goal of minimum invasiveness is to minimize the added morbidity of a...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Amr Elwany, Ahmed Farhoud, Ihab Zidan, Wael Khedr
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2017
Materias:	lumbar discectomy microendoscopic discectomy recurrent disc minimally invasive surgery Endospine Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/76cfea9219074e31b42216afa66f4067
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:76cfea9219074e31b42216afa66f4067
record_format	dspace
spelling	oai:doaj.org-article:76cfea9219074e31b42216afa66f40672021-12-02T03:08:52ZThree-year Follow-Up Results of Lumbar Microendoscopic Discectomy (MED): A Prospective Study in 150 PatientsDOI:10.21608/ESJ.2017.71212314-89502314-8969https://doaj.org/article/76cfea9219074e31b42216afa66f40672017-10-01T00:00:00Zhttp://www.esj.journals.ekb.eg/article_7121.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: The goal of all described surgical techniques to treat lumbar disc prolapse is removing the offending disc material, decompressing the nerve root, and relieving neurologic symptoms while avoiding complications. The goal of minimum invasiveness is to minimize the added morbidity of a larger exposure; including the creation of perineural scarring. Microendoscopic discectomy (MED) is a minimally invasive technique to treat lumbar disc prolapse. It is unique in that it combines open surgical principles with endoscopic technology. Follow-up will show whether MED will improve upon the long-term results of the “gold standard” procedures. Purpose: To evaluate the efficacy of lumbar MED, regarding results, safety, complications, stability of effectiveness, incidence of recurrence, instability and redo surgeries after 3 years of follow up. Study Design: A prospective clinical case study Patients and Methods: We report 150 patients with lumbar disc prolapse, admitted at the Neurosurgery Department; Alexandria Main University Hospital and operated with MED technique. Patients were followed for 3 years. Clinical and radiological data were collected preoperatively and postoperativly. The degree of pain and disability were assessed using VAS and ODI. The length of the incision, the duration of surgery, and the average operative blood loss were calculated. Patients were followed at 2 weeks, 3 months, 1 year and 3 years. Results: This study included 150 patients; with 162 levels operated. 138 patients (92 %) had single level and 12 patients (8%) had double level surgery. L4-5 was the most common level. The mean duration of surgery was 55.0 minutes. The mean blood loss was 40.0 cc. The mean duration of hospital stay was 1.3 day. 81.3% of patients returned to their work in less than four weeks. The average length of skin incision was 2.38 cm. Intraoperative complications included four dural tears (2.6%), one (0.6%) pseudomeningocele, one (0.6%) partial nerve root injury (L5 root), and 3 (2%) superficial wound infection. No patient had postoperative instability or recurrences in the follow up period. There was a statistically significant difference between preoperative and postoperative VAS and ODI in the follow up evaluations (at 2 weeks, 3 months, 1 year & 3 years) (P=<0.001). Conclusion: MED technique allowed nerve root decompression; with minimal complications and preserving normal anatomy, with faster recoveries. For surgeons accustomed to performing endoscopic surgery, the use of MED is a safe and reliable alternative to microscopic discectomy. (2017ESJ124)Amr ElwanyAhmed Farhoud Ihab Zidan Wael KhedrEgyptian Spine Associationarticlelumbar discectomymicroendoscopic discectomyrecurrent discminimally invasive surgeryEndospineNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 24, Iss 1, Pp 14-24 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	lumbar discectomy microendoscopic discectomy recurrent disc minimally invasive surgery Endospine Neurology. Diseases of the nervous system RC346-429
spellingShingle	lumbar discectomy microendoscopic discectomy recurrent disc minimally invasive surgery Endospine Neurology. Diseases of the nervous system RC346-429 Amr Elwany Ahmed Farhoud Ihab Zidan Wael Khedr Three-year Follow-Up Results of Lumbar Microendoscopic Discectomy (MED): A Prospective Study in 150 Patients
description	Background Data: The goal of all described surgical techniques to treat lumbar disc prolapse is removing the offending disc material, decompressing the nerve root, and relieving neurologic symptoms while avoiding complications. The goal of minimum invasiveness is to minimize the added morbidity of a larger exposure; including the creation of perineural scarring. Microendoscopic discectomy (MED) is a minimally invasive technique to treat lumbar disc prolapse. It is unique in that it combines open surgical principles with endoscopic technology. Follow-up will show whether MED will improve upon the long-term results of the “gold standard” procedures. Purpose: To evaluate the efficacy of lumbar MED, regarding results, safety, complications, stability of effectiveness, incidence of recurrence, instability and redo surgeries after 3 years of follow up. Study Design: A prospective clinical case study Patients and Methods: We report 150 patients with lumbar disc prolapse, admitted at the Neurosurgery Department; Alexandria Main University Hospital and operated with MED technique. Patients were followed for 3 years. Clinical and radiological data were collected preoperatively and postoperativly. The degree of pain and disability were assessed using VAS and ODI. The length of the incision, the duration of surgery, and the average operative blood loss were calculated. Patients were followed at 2 weeks, 3 months, 1 year and 3 years. Results: This study included 150 patients; with 162 levels operated. 138 patients (92 %) had single level and 12 patients (8%) had double level surgery. L4-5 was the most common level. The mean duration of surgery was 55.0 minutes. The mean blood loss was 40.0 cc. The mean duration of hospital stay was 1.3 day. 81.3% of patients returned to their work in less than four weeks. The average length of skin incision was 2.38 cm. Intraoperative complications included four dural tears (2.6%), one (0.6%) pseudomeningocele, one (0.6%) partial nerve root injury (L5 root), and 3 (2%) superficial wound infection. No patient had postoperative instability or recurrences in the follow up period. There was a statistically significant difference between preoperative and postoperative VAS and ODI in the follow up evaluations (at 2 weeks, 3 months, 1 year & 3 years) (P=<0.001). Conclusion: MED technique allowed nerve root decompression; with minimal complications and preserving normal anatomy, with faster recoveries. For surgeons accustomed to performing endoscopic surgery, the use of MED is a safe and reliable alternative to microscopic discectomy. (2017ESJ124)
format	article
author	Amr Elwany Ahmed Farhoud Ihab Zidan Wael Khedr
author_facet	Amr Elwany Ahmed Farhoud Ihab Zidan Wael Khedr
author_sort	Amr Elwany
title	Three-year Follow-Up Results of Lumbar Microendoscopic Discectomy (MED): A Prospective Study in 150 Patients
title_short	Three-year Follow-Up Results of Lumbar Microendoscopic Discectomy (MED): A Prospective Study in 150 Patients
title_full	Three-year Follow-Up Results of Lumbar Microendoscopic Discectomy (MED): A Prospective Study in 150 Patients
title_fullStr	Three-year Follow-Up Results of Lumbar Microendoscopic Discectomy (MED): A Prospective Study in 150 Patients
title_full_unstemmed	Three-year Follow-Up Results of Lumbar Microendoscopic Discectomy (MED): A Prospective Study in 150 Patients
title_sort	three-year follow-up results of lumbar microendoscopic discectomy (med): a prospective study in 150 patients
publisher	Egyptian Spine Association
publishDate	2017
url	https://doaj.org/article/76cfea9219074e31b42216afa66f4067
work_keys_str_mv	AT amrelwany threeyearfollowupresultsoflumbarmicroendoscopicdiscectomymedaprospectivestudyin150patients AT ahmedfarhoud threeyearfollowupresultsoflumbarmicroendoscopicdiscectomymedaprospectivestudyin150patients AT ihabzidan threeyearfollowupresultsoflumbarmicroendoscopicdiscectomymedaprospectivestudyin150patients AT waelkhedr threeyearfollowupresultsoflumbarmicroendoscopicdiscectomymedaprospectivestudyin150patients
_version_	1718401925563547648

Three-year Follow-Up Results of Lumbar Microendoscopic Discectomy (MED): A Prospective Study in 150 Patients

Ejemplares similares