Clinical Outcome of Minimally Invasive Tubular Retractor Assisted Microscopic Discectomy in Far Lateral Lumbar Disc Herniation

ABSTRACT

OBJECTIVE: The purpose of this study is to analyze the clinical outcomes of the minimally invasive approach for the surgical treatment of far lateral lumbar disc herniation. METHODS: Between January 2007 and May 2009, 19 patients who underwent minimally invasive, tubular retractor-assisted microscopic discectomy were retrospectively reviewed. The patients included 11 men and eight women with a mean age of 58 years. The mean symptom duration before surgery was 6.5 months, and the mean follow up time was 20.5 months. Clinical outcomes were assessed according to neurologic status, bleeding volume, surgical time, length of hospital stay, visual analogue scale (VAS) and the modified MacNab's criteria. RESULTS: The most frequent lesion was at the L4-L5 level (53%), and the mean bleeding volume was 59.3ml. The mean surgical time and length of hospital stay were 91.1 minutes and 6.4 days, respectively. The mean VAS for radicular pain was improved from 8.37 +/- 1.11 before surgery to 1.37 +/- 1.33 (P<0.05) at discharge and 0.68 +/- 0.89 one year after surgery. The mean VAS for back pain was decreased from 4.6 3 +/- 0.99 before surgery to 2.00 +/- 1.23 (P<0.05) at discharge and 0.42 +/- 0.61 one year after surgery. The success rates were 100% according to the modified MacNab's criteria, and there were no postoperative complications or recurrences. CONCLUSIONS: The minimally invasive, tubular retractor-assisted microscopic discectomy method is a safe and effective procedure and may be an alternative for treating far lateral lumbar disc herniations.