P Kambin1, M H Savitz. 1. Department of Orthopedic Surgery, Allegheny University Hospitals, MCP-Hahnemann School of Medicine, Philadelphia, PA, USA.
Abstract
OBJECTIVE: To assess minimally invasive spinal surgery under endoscopic magnification and illumination (arthroscopic microdiscectomy) as a reliable alternative to open microsurgery for most herniated lumbar discs. METHOD: A total of 600 cases are evaluated retrospectively in terms of patient selection and technique. One series of 300 operations was performed by a key academician in the development of arthroscopic microdiscectomy. A second series of 300 patients was treated by a neurosurgeon in private suburban practice. RESULTS: In terms of patients self-evaluation, satisfactory outcome rates of 85-92% were realized. The patients considered brief intravenous anesthesia and same-day scheduling preferable to general anesthesia and hospitalization needed for open laminotomy and discectomy. Fewer than 2% of the cases required a second surgery. CONCLUSION: The authors are of the opinion that advantages include: (1) one-hour operative time, (2) negligible blood loss, (3) avoidance of significant scarring in the spinal canal, and (4) anterolateral fenestration of the annulus for continuing relief of intradiscal pressure and nerve root decompression.
OBJECTIVE: To assess minimally invasive spinal surgery under endoscopic magnification and illumination (arthroscopic microdiscectomy) as a reliable alternative to open microsurgery for most herniated lumbar discs. METHOD: A total of 600 cases are evaluated retrospectively in terms of patient selection and technique. One series of 300 operations was performed by a key academician in the development of arthroscopic microdiscectomy. A second series of 300 patients was treated by a neurosurgeon in private suburban practice. RESULTS: In terms of patients self-evaluation, satisfactory outcome rates of 85-92% were realized. The patients considered brief intravenous anesthesia and same-day scheduling preferable to general anesthesia and hospitalization needed for open laminotomy and discectomy. Fewer than 2% of the cases required a second surgery. CONCLUSION: The authors are of the opinion that advantages include: (1) one-hour operative time, (2) negligible blood loss, (3) avoidance of significant scarring in the spinal canal, and (4) anterolateral fenestration of the annulus for continuing relief of intradiscal pressure and nerve root decompression.