A Simple New Cost-Effective Retractor System for Exposure in Lumbar Microdiscectomy: 1-Year Outcome Analysis

To introduce a new technique for retraction in lumbar microdiscectomy, the rubber band technique (RT), and compare 1-year clinical outcomes of the technique with standard microdiscectomy (SM).

In this retrospective analysis, 81 consecutive patients with single-level lumbar disc herniation underwent lumbar microdiscectomy by either RT or SM. The primary outcome was Oswestry Disability Index score 1 year after surgery. Secondary outcomes included Short-Form Health Survey (SF-36) physical functioning subscale score, SF-36 bodily pain subscale score, and visual analog scale back pain and leg pain scores. Other parameters were operative time, hospital stay, skin incision, complications, and redo surgery.

Of 81 patients, 93% (76 patients) had complete data up to 1-year follow up. The RT group comprised 39 patients (20 males, 19 females), and the SM group comprised 37 patients (19 males 18 females). Primary and secondary outcomes Oswestry Disability Index score, SF-36 physical functioning score, SF-36 bodily pain score, VAS back and leg pain scores, complications, and redo surgery did not differ significantly between the treatment groups at follow-up points (P > 0.05). Skin incision was smaller in the RT group compared with the SM group (P = 0.0001).

Over the 1-year follow-up period, clinical outcomes of patients treated with RT were comparable to patients treated with SM. RT appears to be an alternative safe, effective, and economical approach for lumbar microdiscectomy.