gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

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Standard open microdiscectomy versus minimally invasive microdiscectomy for lumbar disc herniations – preliminary results of a prospective randomized study

Standard-Mikrodiskektomie versus minimal-invasive Mikrodiskektomie – vorläufige Ergebnisse einer prospektiv randomisierten Studie

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  • corresponding author Y. Ryang - Neurochirurgische Klinik, Universitätsklinikum, Rheinisch-Westfälische Technische Hochschule Aachen
  • J. Kneisel - Neurochirurgische Klinik, Universitätsklinikum, Rheinisch-Westfälische Technische Hochschule Aachen
  • M.F. Oertel - Neurochirurgische Klinik, Universitätsklinikum, Rheinisch-Westfälische Technische Hochschule Aachen
  • P. Reinacher - Neurochirurgische Klinik, Universitätsklinikum, Rheinisch-Westfälische Technische Hochschule Aachen
  • J.M. Gilsbach - Neurochirurgische Klinik, Universitätsklinikum, Rheinisch-Westfälische Technische Hochschule Aachen
  • V. Rohde - Abteilung Neurochirurgie, Zentrum Neurologische Medizin, Universitätsklinikum, Georg-August-Universität Göttingen

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocSA.04.01

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2006/06dgnc104.shtml

Published: May 8, 2006

© 2006 Ryang et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: As lumbar discectomy is one of the most common neurosurgical procedures, new surgical approaches and techniques are being introduced constantly. While theoretically superior, they have to prove reliable and effective in neurosurgical practice. Our aim was the comparison of well established standard open microdiscectomy (SOM) and minimally invasive trocar approach (MIT) for microsurgery of single level lumbar disc herniations.

Methods: 44 patients were randomized into two groups consisting of 22 patients each. Group 1 (8 f, 14 m, median 36 y) received SOM, group 2 (14 f, 8 m, median 39 y) MIT. Operating time, intraoperative blood loss, complication rate, surgical outcome, postoperative pain relief evaluated on a visual analogue scale (VAS) and duration of hospital stay were analyzed. Mean follow-up time was 12 months postoperatively.

Results: Postoperative pain relief was excellent and highly significant in both groups (95%, p=0.00, Wilcoxon-test). The mean VAS was 6.8 (±SD 2.4 SOM) and 6.9 (±SD 2.5 MIT) preoperatively and 2(±2.5 SOM) and 1.3 (±1.7 MIT) postoperatively. Overall analysis of the above mentioned parameters including improvement of sensory/motor deficits (MIT 90%/100%, SOM 87%/90%) yielded good to excellent results in both groups, slightly in favor of the MIT group. The complication rate was even markedly lower in the MIT compared to the SOM group.

Conclusions: A proper selection of patients and the necessary surgical skills provided, the minimally invasive trocar technique is a feasible alternative to standard open microdiscectomy. With its less traumatic approach and smaller skin incision it yields comparable or even better clinical and cosmetic results.