Minim Invasive Neurosurg 2007; 50(6): 335-339
DOI: 10.1055/s-2007-993202
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Microendoscopic Discectomy for Lumbar Disc Herniation with Bony Fragment Due to Apophyseal Separation

M. Matsumoto 1 , K. Watanabe 1 , T. Tuji 2 , K. Ishii 2 , H. Takaishi 2 , M. Nakamura 2 , K. Chiba 2 , Y. Toyama 2
  • 1Department of Advanced Therapy for Spine and Spinal Cord, School of Medicine, Keio University, Tokyo, Japan
  • 2Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, Japan
Further Information

Publication History

Publication Date:
22 January 2008 (online)

Abstract

The purpose of this study was to elucidate the feasibility of microendoscopic discectomy (MED) for the treatment of lumbar disc herniation with a bony fragment due to apophyseal separation. Eighteen patients with low back pain and unilateral sciatic pain due to lumbar disc herniation with a bony fragment were treated by MED using the unilateral approach (15 males and three females; mean age, of 28.9 years; mean follow-up period, 21.1 months); 18 age-and sex-matched patients with lumbar disc herniation without a bony fragment treated by MED served as the control group. The clinical outcomes were evaluated using the Japanese Orthopedic Association Score for Low Back Pain (JOA scores; maximum score, 29 points). Evaluation of the results revealed that good surgical outcomes equivalent to those in the control group were obtained in the subjects of LDH with a bony fragment (JOA scores; 14.1±3.5 in the patient group vs.15.4±2.6 in the control group before surgery; 26.3±1.8 in the patient group vs. 26.9±1.3 at follow-up after the surgery). Although the mean surgical time was significantly longer in the patient group, there were no intra- or postoperative complications in either group. We conclude that MED using the unilateral approach is a feasible minimally invasive surgical option for patients of lumbar disc herniation with an apophyseal bony fragment.

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Correspondence

M. MatsumotoMD 

Department of Orthopaedic Surgery

School of Medicine

Keio University

35 Shinanomachi

Shinjuku-ku

Tokyo 160-8582

Japan

Phone: +81/3/3353 12 11

Fax: +81/3/3353 65 97

Email: morio@sc.itc.keio.ac.jp