J Korean Neurosurg Soc.  2010 Sep;48(3):225-229. 10.3340/jkns.2010.48.3.225.

Minimally Invasive Muscle Sparing Transmuscular Microdiscectomy : Technique and Comparison with Conventional Subperiosteal Microdiscectomy during the Early Postoperative Period

• Park BS
• Kwon YJ
• Won YS
• Shin HC

• KMID: 2066809
• DOI: http://doi.org/10.3340/jkns.2010.48.3.225

Abstract

OBJECTIVE
The authors introduce a minimally invasive muscle sparing transmuscular microdiscectomy (MSTM) to treat herniated lumbar disc disease. Its results are compared with conventional subperiosteal microdiscectomy (CSM) to validate the effectiveness.
METHODS
Muscle sparing transmuscular microdiscectomy, which involves muscle dissection approach using the natural fat cleavage plane between the multifidus to expose the interlaminar space, was performed in 23 patients to treat a single level unilateral lumbar radiculopathy. The creatine phosphokinase (CPK)-MM serum levels were measured on admission and at 1, 3, and 5 days postoperatively. Postoperative pain was evaluated using a 10-point visual analogue scale (VAS) and recorded on admission and at 1, 3, and 5 days postoperatively. The results were compared to those from the conventional subperiosteal microdiscectomy (43 patients).
RESULTS
The CPK-MM levels were significantly lower in the serum of the MSTM group compared to the CSM group on postoperative days three and five (p = 0.03 and p = 0.02, respectively). The clinical scales for back pain using VAS were significantly lower in the MSTM group than in the CSM group on postoperative days three (p = 0.04). The mean VAS scores for leg pain in both groups showed no significant differences during the early postoperative period.
CONCLUSION
Muscle sparing transmuscular microdiscectomy is a minimally invasive surgical option to treat lumbar radiculopathy due to herniated disc. The approach affected minimal injury to posterior lumbar supporting structures with alleviated postoperative back pain.

Keyword

Lumbar spine; Muscle sparing technique; Microdiscectomy; Minimally invasive surgery

MeSH Terms

Back Pain
Creatine Kinase
Humans
Intervertebral Disc Degeneration
Intervertebral Disc Displacement
Leg
Muscles
Pain, Postoperative
Postoperative Period
Radiculopathy
Weights and Measures
Creatine Kinase
Intervertebral Disc Degeneration
Intervertebral Disc Displacement