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Arthroscopic microdiscectomy and selective fragmentectomy
1Department of Orthopaedic Surgery, Medical College of Pennsylvania, Philadelphia, USA.
Clinical Orthopaedics and Related Research
|April 1, 1998
Summary
Posterolateral arthroscopic discectomy demonstrated high efficacy for lumbar disc herniation. The study found a low complication rate, with most cases resolving successfully.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Minimally Invasive Procedures
Background:
- Lumbar disc herniation is a common cause of radicular pain.
- Posterolateral arthroscopic discectomy offers a minimally invasive surgical option.
- Evaluating the efficacy and safety of this approach is crucial for patient outcomes.
Purpose of the Study:
- To assess the efficacy and complication rates of posterolateral arthroscopic discectomy.
- To compare outcomes between bilateral biportal and unilateral uniportal approaches.
- To determine the long-term success of the procedure for lumbar disc herniation.
Main Methods:
- Prospective outcome study of 175 patients with lumbar disc herniation.
- 169 patients available for follow-up (minimum 24 months).
- Bilateral biportal approach for central/sequestered herniations; unilateral uniportal for paramedial/foraminal/extra-foraminal herniations.
Main Results:
- 149 (88.2%) procedures were successful.
- 20 (11.8%) procedures failed due to persistent radicular symptoms.
- Low complication rate: 1 disc space infection, 1 transient peroneal neuropraxia, 4 skin hypersensitivities; all resolved without sequelae.
Conclusions:
- Posterolateral arthroscopic discectomy is an effective procedure for lumbar disc herniation.
- The technique has a low rate of significant complications.
- Both bilateral biportal and unilateral uniportal approaches demonstrated good outcomes.