Learning Curve of Microendoscopic Discectomy for the Treatment of Lumbar Disc Herniation

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• 作者：R. Casal-Moro^a ; ^{roberto.casal.moro@sergas.is} ; M. Castro-Mené ; ndez^b ; V. Del Campo-Pé ; rez^c ; M. Herná ; ndez-Blanco^a ; F.J. Jorge-Barreiro^d
• 关键词：Microendoscopic discectomy ; Learning curve ; Lumbar disc herniation ; Minimally invasive spine surgery
• 刊名：Revista Espa?ola de Cirug¨ªa Ortop¨¦dica y Traumatolog¨ªa (English Edition)
• 出版年：2010
• 出版时间：2010
• 年：2010
• 卷：54
• 期：5
• 页码：272-279
• 全文大小：722 K

文摘

Objective

To evaluate the learning curve of the Microendoscopic Discectomy (MED) for the treatment of lumbar disc herniation.

Material and methods

Prospective observational clinical study of 120 patients operated by MED technique. The learning curve was assessed using surgery time, complication rate and conversion rate. The relief of pain, improvement of functional status and patient satisfaction were also assessed. The follow-up time after surgery was 5 years in all cases.

Results

The duration of surgical operating time decreased over the course of the study to stabilise around 62-69min. There were complications in 14 patients (11.7 % ), the most frequent of which was incidental durotomy (3 cases, all during the learning curve period). There were six (5 % ) conversions to open discectomy (4 patients in the first 30 cases). After this stage, conversion to open procedure was exceptional and there were no complications related to technique. The MED is a predictable and safe procedure that can treat all types of herniated discs through an 18 mm incision without detaching the muscles, providing similar results to those obtained with conventional techniques, as it is based on the same surgical principles.