Clinical comparison between micro-endoscopic discectomy(MED)and open discectomy for treatment of lumbar disc herniation

Objective:To compare between micro-endoscopic discectomy (MED)and open decompression discectomy,and assess the clinical value of MED. Methods:Two hundreds and sixty-one cases who suffered from lumbar disc herniation had a retrospective study. One hundred and twenty-one of 261 patients were treated with MED including 72 male and 52 female with an average age of 37.6 years ranging 26 to 63,the segment of herniated discs were at L4,5 in 66 and at L5S1 in 58. The other 137 patients were treated with decompression by fenestration and discectomy including 66 male and 71 female with an average age of 44.5 years ranging 25 to 71,the segment of herniated discs were at L4,5 in 64 and at L5S1 in 73. MED was performed via a small paracentral approach to have thorough root exploration,direct decompression and remove nucleus gelations by endoscopes. Open decompression discectomy was performed decompression by fenestration and discectomy. Results:MED group were followed up for 14.5 months on average,the operative time was(85±15)minutes and blood loss was(50±10) ml,time of la- ying in bed after operation was(50±8) hours. Open decompression group were followed up for 15.5 months on average,operati- ve time was(60±15) minutes and blood loss was(80±20) ml,time of laying bed after operation was(150±24)hours. MED group needed significantly less narcotic medication after operation than open decompression group. According to modified Macnab criteria,the results were excellent in 94,good in 25,fair in 5 in MED group and excellent in 101,good in 28,fair in 8 in open decompression group. Conclusion:As compared with open decompression group,MED offers a similar short-term clinical outcome,but with smaller incision,less tissue trauma and quicker recovery.