J Minim Invasive Spine Surg Tech.  2020 Oct;5(2):51-56. 10.21182/jmisst.2020.00129.

Tubular Discectomy Versus Conventional Microdiscectomy for the Treatment of Lumbar Disc Herniation: A Comparative Study

• Asati S
• Jain S
• Kundnani VG

• KMID: 2562063
• DOI: http://doi.org/10.21182/jmisst.2020.00129

Abstract

Objective
The study aims to compare the outcomes of micro-lumbar discectomy (MLD) with tubular micro-endoscopic discectomy (MED).
Methods
A retrospective analysis of 414 patients who underwent single-level lumbar discectomy either by tubular MED or MLD between 2008-2016 was performed. Demographics, surgical duration, intraoperative blood loss, total hospital stay, visual analogue scale (VAS) pain score, Oswestry disability index (ODI) score before and after the surgery and complications were evaluated between the groups.
Results
Out of the 414 patients, 217 patients were treated with MLD and 197 by tubular MED. The mean age in MLD and tubular MED group was 44.7 and 42.4 years. There was a significant improvement in VAS and ODI scores at 2 weeks in both the groups, without any significant difference. Average surgical time was shorter and the average blood loss was higher in MLD as compared to the MED group. Average hospital stay in MED (1.03 days) was significantly less than MLD group (1.91 days). There were similar incidences of dural tear in both the groups, however, more patients had wound infection in the MLD group.
Conclusion
Lumbar discectomy either by tubular MED or MLD are very safe and effective means of treating disc herniation related sciatic pain. Patients who underwent minimally invasive tubular micro-endoscopic discectomy were found to have similar outcomes as those of who underwent micro-lumbar discectomy. However, given the learning curve associated with minimally invasive approaches to clinical practice, these modest clinical benefits probably do not warrant the transition from a standard microsurgical approach to a minimally invasive approach.

Keyword

Dural tear; Lumbar disc prolapse; Micro-endoscopic discectomy (MED); Microlumbar discectomy (MLD)