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Minimally invasive microscopically assisted lumbar discectomy using the METRx X-Tube system
Przemysław Kunert1, Paweł Kowalczyk, Andrzej Marchel
1Przemysław Kunert, Katedra i Klinika Neurochirurgii, Warszawski Uniwersytet Medyczny, ul. Banacha 1 A, 02-097 Warszawa. pkunert@wp.pl
Background And Purpose:
Lumbar discectomy with the METRx X-Tube system and operating microscope is a modification of microendoscopic discectomy. The aim of this study was to describe this method and present the results of treatment of the first 13 patients.
Material And Methods:
Under general anaesthesia and fluoroscopic guidance, a guidewire was placed over the inferior aspect of the superior lamina. A 2.5-3 cm midline skin incision was made, followed by paramedian lumbar fascia incision. Then, dilators were sequentially introduced (muscle-splitting approach). Finally, a tubular retractor was fixed directly over the interlaminar space. Further stages of the procedure were performed using an operating microscope and standard microdiscectomy equipment. The first 13 consecutive patients operated on using this method were analysed. Twelve patients were operated on at one level and 1 at two levels. Disc herniation was centro-lateral in 10 cases, lateral in 2 and central (broad-based) in 2 patients.
Results:
Regression of radicular pain was noted in all patients. No postoperative complications were observed except for prolongation of wound healing in 2 patients. According to mo-dified MacNab criteria, excellent late outcome was achieved in 8 patients and good in 4 patients. There were no cases of recurrent radicular pain or need for surgical revision for herniation recurrence. One patient was reoperated on because of low back pain (implantation of an interspinous spacer).
Conclusions:
Microscopically assisted lumbar discectomy using the METRx X-Tube system seems to be safe and effective. This method combines the advantages of modern minimally invasive techniques while avoiding the limitations of endoscopy.
Insights
Lumbar discectomy using the METRx X-Tube and microscope is safe and effective for radicular pain. This minimally invasive technique offers advantages over traditional endoscopy.
Area of Science:
- Neurosurgery
- Minimally Invasive Spine Surgery
Background:
- Microendoscopic discectomy is a minimally invasive surgical technique.
- The METRx X-Tube system combined with an operating microscope offers a modification of this approach.
Purpose of the Study:
- To describe the technique of lumbar discectomy using the METRx X-Tube system and operating microscope.
- To present the treatment outcomes of the first 13 patients who underwent this procedure.
Main Methods:
- A muscle-splitting approach was used with sequential dilator introduction.
- A tubular retractor was placed over the interlaminar space.
- The procedure was completed using an operating microscope and standard microdiscectomy instruments.
Main Results:
- All 13 patients experienced regression of radicular pain.
- Excellent or good outcomes were achieved in all patients based on modified MacNab criteria.
- No recurrent disc herniation or need for revision surgery for recurrence was observed.
Conclusions:
- Microscopically assisted lumbar discectomy with the METRx X-Tube system is a safe and effective procedure.
- This technique combines the benefits of minimally invasive surgery while mitigating endoscopic limitations.
