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J Neurol Surg A Cent Eur Neurosurg 2017; 78(05): 446-452
DOI: 10.1055/s-0037-1598657
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Long-Term Outcome of Microendoscopic Diskectomy for Lumbar Disk Herniation. A Clinical Study of Consecutive 112 Cases with More than 5-Year Follow-Up

Mitsunori Yoshimoto
1   Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan
,
Noriyuki Iesato
1   Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan
,
Yoshinori Terashima
1   Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan
,
Katsumasa Tanimoto
1   Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan
,
Tsuneo Takebayashi
1   Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan
,
Toshihiko Yamashita
1   Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan
› Institutsangaben
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Publikationsverlauf

06. April 2016

20. Dezember 2016

Publikationsdatum:
01. März 2017 (online)

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Abstract

Background Clinical results and recurrence rate after microendoscopic diskectomy (MED) with long-term follow-up is still unclear, in spite of its relatively long history.

Materials and Methods A total of 112 who underwent MED participated in this study. Operative time, blood loss, serum C-reactive protein (CRP), creatine kinase (CK), and visual analog scale (VAS) were evaluated as indexes of surgical invasiveness. The 36-Item Short Form Survey Instrument (SF-36), Japanese Orthopaedic Association (JOA) score, patient satisfaction, and recurrence were also evaluated with a follow-up of at least 5 years.

Results The mean operative time was 86.7 minutes, and the mean blood loss was 35.7 mL. The mean CRP on postoperative day 3 and CK on the first postoperative day was 0.72 mg/dL and 224.6 IU/L, respectively, and VAS to assess surgical site pain on the first postoperative day was 24.9 mm on average. The improvement rate in the JOA score was 68.7%. The physical component summary of SF-36 in norm-based scoring was improved from 23.4 to 48.6. Overall, 90.8% of patients evaluated their response to the surgery as extremely satisfied or satisfied. The recurrence rate was 10.5%, and reoperation was performed in 7.9% of patients.

Conclusions MED is a technique that offers both reduced invasiveness and good long-term clinical results.

Keywords

lumbar disk herniation - microendoscopic diskectomy - long-term clinical results