[Short-term effectiveness of quadrant retractor in treatment of recurrent lumbar disc protrusion]

To investigate the effectiveness of Quadrant retractor for the treatment of recurrent lumbar disc protrusion.

Between July 2008 and March 2010, 18 cases of recurrent lumbar disc protrusion were treated with Quadrant. There were 13 males and 5 females with an average age of 43 years (range, 35-67 years). Involved segments included L4, 5 in 6 cases and L5, S1 in 12 cases. The time between first operation and recurrence was 12-120 months (mean, 42.8 months). Before operation, radiological evaluation including X-ray, CT, and MRI were performed. Visual analogue scale (VAS) score and modified MacNab criteria were used to evaluate the effectiveness.

The operation time was 40-80 minutes (mean, 60 minutes), and the amount of blood loss was 80-120 mL (mean, 100 mL). All operations were performed successfully, and no complication of infection and nerve injury occurred. Incisions healed by first intention. Cerebrospinal fluid leakage occurred in 2 cases and was cured at 3 days after operation by removal of drainage. Eighteen patients were followed up 12-30 months (mean, 22 months). The VAS score of leg pain was decreased from 7.3 +/- 2.2 preoperatively to 2.0 +/- 1.3 at the final follow-up, showing significant difference (t = 11.08, P = 0.00). According to modified MacNab criteria, the results were excellent in 12 patients and good in 6 patients. No recurrence was found during follow-up.

Discectomy via Quadrant retractor is a safe and effective minimally invasive surgical technique in treating recurrent lumbar disc protrusion.