Advantages of Microendoscopic DiscectomySurgeons from China describe the use and results of a new treatment method for minimally invasive discectomy. The procedure is called a microendoscopic discectomy (MED). It was done on 873 patients with disc herniation. Results were compared to a control group of patients treated with open discectomy for the same problem. All patients were treated by the same surgeon in the same hospital.
A special endoscopic instrument called the MEDTRx system was used. Detailed drawings and photographs of the equipment and patient position are included. With this system, the surgeon is able to see a high-quality image of the disc and surrounding tissues on a video screen. MED allows the surgeon to use both microsurgical and endoscopic techniques.
The authors report that pain was improved equally in both groups. Recovery time in the MED group was much faster. Patients' stay in the hospital was shorter. They were able to return to work and to their daily activities faster.
With the smaller incision, there was less bleeding and less tissue trauma. Only a light anesthesia was need so the side effects of general anesthesia were avoided. There is also less trauma to the nerve root because the patient could tell the surgeon if there is any pain or numbness during the procedure. Operative time decreased as the surgeon gained experience with this new technique.
MED isn't for every patient with disc problems. The best patient for this procedure is someone who has a single-level disc protrusion causing sciatica. Older adults with spinal stenosis (narrowing of the spinal canal) are not good candidates for MED. Patients with spinal instability are also poor candidates.
With time and effort, surgeons can obtain the necessary training and practice to use this new three-dimensional treatment for patients with disc herniation.
Xiaotao Wu, MD, et al. Microendoscopic Discectomy for Lumbar Disc Herniation. In Spine. November 1, 2006. Vol. 31. No. 23. Pp. 2689-2694.
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