Microendoscopic lumbar discectomy

Technical note

Mick J. Perez-Cruet, Kevin Foley, Robert E. Isaacs, Lauri Rice-Wyllie, Robin Wellington, Maurice M. Smith, Richard G. Fessler

Research output: Contribution to journalArticle

206 Citations (Scopus)

Abstract

OBJECTIVE: The microendoscopic discectomy (MED) technique was initially developed in 1997 to treat herniated lumbar disc disease. Since then, thousands of cases have been successfully performed at more than 500 institutions. This article discusses the technical aspects of this procedure and presents a consecutive case series. METHODS: A total of 150 consecutive patients underwent MED. MED is performed by a muscle-splitting approach using a series of tubular dilators with consecutively increasing diameters. A tubular retractor is then inserted over the final dilator, and a specially designed endoscope is placed inside the tubular retractor. The microdiscectomy is performed endoscopically while the surgeon views the procedure on a video monitor. RESULTS: Clinical outcomes were determined using a modified MacNab criteria, which revealed that 77% of patients had excellent, 17% had good, 3% had fair, and 3% had poor outcomes. The average hospital stay was 7.7 hours. The average return to work period was 17 days. Complications primarily included dural tears, which occurred in 8 patients (5%) and were seen early on in the patient series. Complication rates diminished as the surgeon's experience with this technique increased. CONCLUSION: MED for lumbar herniated disc disease can be performed safely and effectively, resulting in a shortened hospital stay and faster return to work; however, there is a learning curve to this procedure.

Original languageEnglish (US)
Pages (from-to)129-136
Number of pages8
JournalNeurosurgery
Volume51
Issue number5 SUPPL.
StatePublished - Nov 1 2002
Externally publishedYes

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Diskectomy
Intervertebral Disc Displacement
Return to Work
Length of Stay
Learning Curve
Endoscopes
Tears
Muscles
Surgeons
Intervertebral disc disease

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Perez-Cruet, M. J., Foley, K., Isaacs, R. E., Rice-Wyllie, L., Wellington, R., Smith, M. M., & Fessler, R. G. (2002). Microendoscopic lumbar discectomy: Technical note. Neurosurgery, 51(5 SUPPL.), 129-136.

Microendoscopic lumbar discectomy : Technical note. / Perez-Cruet, Mick J.; Foley, Kevin; Isaacs, Robert E.; Rice-Wyllie, Lauri; Wellington, Robin; Smith, Maurice M.; Fessler, Richard G.

In: Neurosurgery, Vol. 51, No. 5 SUPPL., 01.11.2002, p. 129-136.

Research output: Contribution to journalArticle

Perez-Cruet, MJ, Foley, K, Isaacs, RE, Rice-Wyllie, L, Wellington, R, Smith, MM & Fessler, RG 2002, 'Microendoscopic lumbar discectomy: Technical note', Neurosurgery, vol. 51, no. 5 SUPPL., pp. 129-136.
Perez-Cruet MJ, Foley K, Isaacs RE, Rice-Wyllie L, Wellington R, Smith MM et al. Microendoscopic lumbar discectomy: Technical note. Neurosurgery. 2002 Nov 1;51(5 SUPPL.):129-136.
Perez-Cruet, Mick J. ; Foley, Kevin ; Isaacs, Robert E. ; Rice-Wyllie, Lauri ; Wellington, Robin ; Smith, Maurice M. ; Fessler, Richard G. / Microendoscopic lumbar discectomy : Technical note. In: Neurosurgery. 2002 ; Vol. 51, No. 5 SUPPL. pp. 129-136.
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