Clinical Evaluation, Functional Outcome and Complications of MicroEndoscopic Discectomy(MED) in Single or Double Level Lumbar Disc Herniation- A Retrospective Review of 156 Patients

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Volume 2 | Issue 1 | April-September 2021 | page: 06-11 | Hitesh N. Modi, Alkesh Rathod, Utsab Shrestha

Authors: Hitesh N. Modi [1], Alkesh Rathod [1], Utsab Shrestha [1]

[1] Department of Spine Surgery, Zydus Hospital and Healthcare Research Pvt Ltd., Ahmedabad, Gujarat, India.

Address of Correspondence
Dr. Hitesh N. Modi,
Senior Consultant, Department of Spine Surgery, Zydus Hospital and Healthcare Research Pvt Ltd., SG Highway, Thaltej, Ahmedabad, Gujarat, India 380054.
E-mail: drmodihitesh@gmail.com

Abstract

Introduction: Lumbar disc herniation (LDH) is one of the most common causes for low back pain and related disabilities. Surgery is indicated in patients who do not respond to the conservative measures for at least 6 weeks or symptoms are worsened. Microendoscopic discectomy (MED) is a well-accepted minimally invasive surgical technique with similar results compared to open surgery. The purpose of this study was to evaluate the clinical outcome, functional improvement and analyze complications during MED.
Methods: A retrospective analysis was conducted in 156 patients who were operated for single or double level LDH using MED between 2016 and 2018. All patients were evaluated for pain and disability using visual analogue scale (VAS) and Oswestry disability index (ODI), respectively. Modified MabNab’s criteria used to evaluate overall outcome of surgery. Operation time, estimated blood loss (EBL), hospital stay and time to return back to previous activities were evaluated. Complications and revisions were noted during follow-up to analyze clinical results. Paired t-test was used to evaluate statistical difference in VAS and ODI score during follow-up.
Results: All patients were followed up at 6 weeks, 3 months, 6 months, 1 year and yearly thereafter postoperatively. Average follow-up was 25.5±9.7 months and average age was 45.0±12.7 years. Average VAS scores improved significantly from preoperative 8.7±0.8 to 2.0±1.1 postoperatively (p<0.0001). Average preoperative ODI improved significantly from 53.8±6.1 to 22.6±5.1 postoperatively (p<0.0001). Both score were maintained at the final follow-up. The average time to return to previous activity level was 35.7±14.3 days. Average operation time, EBL and hospital stay were 57.6±14.6 minutes, 36.7±13.1 mL and 2.4±0.7 days, respectively. There were total 19 (12.2%) complications and 12 (7.7%) revisions in the series. Overall clinical outcome was excellent, good, fair and poor in 73.1%, 20.5%, 5.1% and 1.3% of cases using modified MacNab’s criteria.
Conclusion: Study of 156 patients operated for single or double level LDH using MED has shown encouraging clinical results and functional outcome with similar complications reported in literature. However, less intraoperative blood loss, shorter hospital stay and early return to work are some of the advantages which favours its wide spread acceptability.
Keywords: Lumbar disc herniation; Microendoscopic discectomy; clinical outcome; Complications.

 

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How to Cite this Article:  Modi HN, Rathod A, Shrestha U | Clinical Evaluation, Functional Outcome and Complications of MicroEndoscopic Discectomy(MED) in Single or Double Level Lumbar Disc Herniation- A
Retrospective Review of 156 Patients | Back Bone: The Spine Journal | April-September 2021;
2(1): 06-11.

 

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