Operative management for the recurrent lumbar disc herniation by microendoscopy discectomy technique / 中国矫形外科杂志

ABSTRACT

[Objective]To investigate the surgical feasibility and efficiency with microendoscopy discectomy technique for the recurrent lumbar disc herniation.[Method]Ninteen cases underwent disc excision with different operative approaches,11 cases had undergone previous surgery with MED,7 cases with conventional approach,2 cases removing whole vertebrate plate approach,3 cases removing half vertebrate plate approach,2 cases with minor vertebrate plate window approach.There were 13 cases of ipsilateral protrusion and 2 cases of contralateral protrusion,3 cases of adjacent segment protrusion.All of these cases were revisioned by MED except for 1 case.[Result]Eighteen cases were finished by MED technique successfully except for 1 case which was changed to open operating.All cases were followed up from 6 months to 2.5 years,averaged 1.5 years.Postoperative JOA score was improved from preoperative average (9.61?3.40)? to average (26.17?2.60) ?,the rate of improvement final was 86.32%.In terms of Macnab scoring system,the satisfactory rate was 88.89%.[Conclusion]MED technique is an effective method for recurrent lumbar herniation,but the operator needs lots of experience in minimal invasive spine surgery.