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Comparison of safety and efficiency of microendoscopic discectomy with automatic nerve retractor and with nerve hook

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Regenerative Biomaterials 2016年第5期3卷 319-322页

作者： He-Ping Yin Yu-PengWang Zhi-Ye Qiu Zhi-Cai Du Yi-Min Wu Shu-Wen Li The Second Affiliated Hospital Inner Mongolia Medical UniversityHohhot 010030China Institute of Regenerative Medical Materials School of Materials Science and EngineeringTsinghua UniversityBeijing 100084China

This study compares the safety and efficiency of two techniques in microendoscopic discectomy(MED)for lumbar disc *** two techniques are MED with automatic nerve retractor and MED with nerve hook which had been widely used for many *** former involves a newly developed MED device which contains three parts to protect nerve roots during *** hundred and twenty-eight patients underwent MED treatments between October 2010 and September 2015 were recruited and randomized to either intraoperative utilization of automatic nerve retractor(n紏315,group A)or application of nerve hook during surgery(n=113,group B).Operation time and intraoperative bleeding volume were ***,Visual Analogue Scales(VAS)and muscle strength grading were performed preoperatively,and 1,2,3 days,1,2 weeks,3 and 6 months *** dramatic difference of pain intensity was observed between the two groups before surgery and 6 months after surgery(P>0.05).The operation time was shorter in group A(30.3061.89 min)than that in group B(59.4163.25 min).Group A(67.83613.14 ml)experienced a significant decrease in the amount of blood loss volume when compared with group B(100.04615.10 ml).There were remarkable differences of VAS score and muscle strength grading after postoperative 1,2,3 days,1,2 weeks and 3 months between both groups(P≤0.05).MED with automatic nerve retractor effectively shortened operation time,decreased the amount of bleeding,down-regulated the incidence of nerve traction injury.

关键词： minimally invasive lumbar discectomy automatic nerve retractor microendoscopic discectomy nerve hook

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microendoscopic discectomy and percutaneous transforaminal endoscopic discectomy in the treatment of lumbar disc herniation:a randomized controlled study and its effect on lumbar function

microendoscopic discectomy and percutaneous transforaminal e...

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中国中西医结合学会神经外科专业委员会第六届学术大会暨广东省中西医结合学会神经外科专业委员会2019年学术年会及继续教育学习班

作者：吕雪丰 Zhang shigang Yu yingxin Zhao Jianmin The Neurosurgery of the Hospital of Fengning Manchu Autonomous County Chengde Medical College Department of anaesthesia the Hospital of Fengning Manchu Autonomous CountyChengde Medical College

Objective To investigate the clinical effects of microendoscopic discectomy(MED) and percutaneous transforaminal endoscopic discectomy(PTED) in the treatment of lumbar disc herniation(LDH) and its effect on lumbar *** 150 patients with LDH admitted in our hospital from October 2014 to October 2016 were randomly divided into control group(n=75) and experimental group(n=75).The control group were treated with MED,and the experimental group were treated with *** operation status of2 groups were *** ODI index,JOA score and lumbar functional recovery were evaluated at preoperation and 3 months *** levels of serum IL-1β,MMP-3 and TNF-a in 2 groups were *** Compared with the control group,the bleeding volume and treatment expenses in experimental group reduced significantly,the incision length,operation time,hospitalization time and walking time shortened significantly(P<0.01).3 months postoperation,the ODI indexes of 2 groups were significantly lower than preoperation,JOA score and lumbar flexion,extension,left flexion,right flexor strength increased significantly,there was significant difference between 2 groups(P<0.05 or P<0.01).The levels of IL-1β,MMP-3 and TNF-α in 2 group decreased gradually from 1 day to 3 months postoperation,and experimental group were lower than that of the control group(P<0.05 or P<0.01).Conclusion PTED has a significant effect on LDH,which can promote the recovery of lumbar function,restrain the inflammatory reaction of the lumbar vertebrae,and has the advantage of small trauma,quick recovery and low cost of treatment,worthy of clinical promotion.

关键词： lumbar disc herniation microendoscopic discectomy percutaneous transforaminal endoscopic discectomy lumbar vertebral function lumbar muscle strength

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Spinal surgeons＇ learning curve for lumbar microendoscopic discectomy： a prospective study of our first 50 and latest 10 cases

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Chinese Medical Journal 2008年第21期121卷 2148-2151页

作者： RONG Li-min XIE Pei-gen SHI De-hai DONG Jian-wen LIU Bin FENG Feng CAI Dao-zhang Department of Orthopaedics Third Affiliated Hospital of Sun Yat-sen University Guangzhou Guangdong 510630 China

Background microendoscopic discectomy （MED） is a minimally invasive operation that allows rapid recovery from surgery for lumbar disc herniation, but has replaced traditional open surgery in few hospitals because most surgeons avoid its long learning curve. We evaluated the effectiveness and safety of lumbar MED at stages of spinal surgeons＇ learning curve. Methods Fifty patients receiving MED from June 2002 to February 2003 were divided into chronological groups of ten each： A-E. The control group F was ten MED patients treated later by the same medical team （September-October 2006）. All operations were performed by the same team of spinal surgeons with no MED experience before June 2002. We compared groups by operation time, blood loss, complications and need for open surgery after MED failure. Results Operation times by group were： A, （107±14） minutes; B, （85±13） minutes; C, （55±19） minutes; D, （52±12） minutes; E, （51±13） minutes; and F, （49±15） minutes. Blood loss were： A, （131±73） ml; B, （75±20） ml; C, （48±16） ml; D, （44±17） ml; E, （45±18） ml; and F, （45±16） ml. Both operation time and blood loss in groups C, D, E and F were smaller and more stable compared with groups A and B. Japanese Orthopedic Association assessment （JOA） score of each group in improvement rate immediately and one year after operation were as follows （in percentage）： A, （79.8±8.8）/（89.8±7.7）; B, （78.6±8.5）/（88.5±7.8）; C, （80.8±11.3）/（90.8±6.7）; D, （77.7±11.4）/（88.9±9.3）; E, （84.0±8.7）/（89.6±9.0）; and F, （77.8±11.6）/ （86.9±8.4）. Groups showed no statistical difference in improvement rates. Complications developed in three patients in group A, two in group B, and none in the other groups. Conclusions Spinal surgeons performing MED become proficient after 10-20 operations, when their skill becomes fairly sophisticated. Patients＇ improvement rate is the same regardless of surgeons＇ phase of learning curve.

关键词： lumbar disc herniation microendoscopic discectomy learning curve spinal surgeons

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