[Lumbar videodiscectomy. Results in a prospective consecutive series]

We report results obtained in a prospective consecutive cohort of patients undergoing videoscopy-guided discectomy using the Destandau technique.

Between June 1998 and August 2000, 40 patients underwent videoscopy-guided discectomy. There were 24 males and 16 females, mean age 43 years (24-78 years). Eleven patients had associated lumbar stenosis. Outcome was reviewed by an independent investigator. Mean follow-up was 19 months (12-67).

One patient required reoperation to establish proof of infection. Three patients required revision for open extended decompression which did not reveal any case of remaining hernia fragment or postoperative hematoma. All three of these patients had lumbar stenosis. At last follow-up 36 patients had not required revision surgery. Mean hospital stay was 3.3 days. The Waddel score was excellent or good for 91% of patients and the Prolo score was excellent or good for 84%. Mean improvement compared with the preoperative status was 65%, as assessed by the Oswestry score.

Lumbar videodiscectomy provides satisfactory functional results equivalent to those of microdiscectomy. The advantages of this technique are the precise control of the operation and the good hemostasis made possible by the optical magnification. Low cost is another advantage since the procedure only requires a standard arthroscopic column and standard spinal surgery instruments. Associated stenosis is a relative contraindication for this minimally invasive technique.