Egyptian Spine Journal (Apr 2018)

Comparing the Extent of Tissue Damage between Lumbar Microendoscopic Discectomy (MED) and Microscopic Discectomy (MD) Using Biochemical Markers

  • Mohamed Abbas,
  • Amr Elwany,
  • Refaat Mohamed

DOI
https://doi.org/10.21608/ESJ.2018.11240
Journal volume & issue
Vol. 26, no. 1
pp. 25 – 33

Abstract

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Background Data: Discectomy through a limited laminotomy has remained the “gold standard” for lumbar disc surgery. Surgery for lumbar disc herniation can be classified into two broad categories;open (conventional) versus minimally invasive surgery, where the last category classified into microscopic, endoscopic and percutaneous procedures. Microendoscopic discectomy (MED) is unique in that it combines open surgical principles with endoscopic technology. Purpose: To evaluate extent of tissue damage and pain relief after microendoscopic (MED) and microscopic lumbar discectomy (MD). Study Design: A prospective randomized controlled study. Patients and Methods: The study included 40 patients having lumbar disc prolapse, operated in Alexandria Main University Hospital. Twenty of them underwent MED (Group A) and the other twenty underwent MD (Group B). Clinical (VAS, ODI) and radiological and biochemical markers (CRP, CPK) for tissue inflammation data were collected preoperatively and postoperatively for comparison. Patients were followed up for 6 months. Results: 26 patients were males and 14 were females. The mean age for group A was 40.8±1.34 years and for group B was 40.2±1.06 years. Clinically all patients had low back pain and radicular leg pain. There was no statistically significant difference between the duration of surgery in both groups. The length of hospital stay was significantly less in MED group. The length of the skin wound was significantly less in MED group. Reduction of back pain VAS immediate and 1 month postoperative was reported in both groups and was statistically significantly better in MED group, however, after 6 months there was no difference between both groups. There was significant improvement with no difference between both groups regarding radicular VAS and ODI all through the follow up. Postoperative CRP and CPK was statistically significantly higher in MD group (P<0.001). Conclusion: Both techniques gave comparable clinical outcomes although early back pain score and tissue markers were in favor of MED technique. (2018ESJ153)

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