Endoscopic Microdiscectomy in Treatment of Hernias of Lumbar Intervertebral Discs: The Method Assessment

Korobova ., Stepanyan ., Onopchenko ., Kadin L., Grigoryan Yu.

Pirogov National Medical Surgical Center, Moscow, Russia;
Clinical Diagnostic Complex N 1, Moscow, Russia

 

The research goal was assessing results of endoscopic microdiscectomy (EMD) according to Destandau J., performed in hernias of lumbar intervertebral discs.

Material and Methods. During 2002-2005 EMD was performed in 163 cases (55 females and 108 males, aged 14-64). The patients suffered from radicular syndrome during 1 month-10 years; duration of the last exacerbation varied from 1 up to 8 months. Repeated conservative treatment gave no stable positive effect. Radicular syndrome was present in all the cases. One could watch motor disorders (77 cases), loss of sensitivity (137), pelvic disturbances (1). There was compression radiculopathy of roots of the following vertebrae: L5 - 57; S1 - 88; L4 - 2; L4 and L5 - 1; L5and S1 - 15 cases. Multilevel lesions, presence of foraminal and extraforaminal hernias were criteria for exclusion of cases from the present research. EMD was performed with endoscopic instruments (Karl Storz, Germany). A patient was in a genupectoral position. Intervention duration was 50 min on the average.

Results and Discussion. Radicular syndrome regressed in all the cases. Transient augmentation of sensitive disorders (up to 2 weeks) was watched in 2 patients. There was no aggravation of motor disturbances. Mean duration of hospitalization was 5 days. One case developed spondylodiscitis. Dura was injured in 4 patients. Not a single patient complained of relapses of endoscopically removed hernias of intervertebral discs.

Conclusion. EMD allows to perform a smaller skin incision and to reduce traumatizing of paravertebral soft tissues and neural structures. It considerably shortens a period of stay in hospital. EMD results can be compared with those of microsurgical discectomy.