Complications following microendoscopic discectomy: Management and prevention / 中国微创外科杂志

ABSTRACT

Objective To summarize the experience of microendoscopic discectomy (MED). Methods A retrospective analysis was made on causes and the management of complications following 115 cases of MED in this hospital from April 2001 to April 2003. Results A conversion to open surgery was required in 13 cases. There were 2 cases of endoscope displacement and 7 cases of dural abruption intraoperatively. Postoperative hematoma pressing on neighbouring nerves was seen in 2 cases but no nerve root injuries were found. All the patients were followed for 3～12 months (mean, 7 5 months). According to the Nakai scale, 70 cases were classified as “excellent”, 36 cases “good”, 7 cases “fair”, and 2 cases “poor”, the “good” or “excellent” rate being 92.2% ( 106/115 ). Conclusions Proper selection of patients, intraoperative localization by “C”-arm X-ray examination, removal of the ligamenta flava and the lamina, detachment of adhesions surrounding the nerve root to obtain a complete exposure, and thorough hemostasia are crucial to minimize the incidence of complications.