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Indian Journal of Orthopaedics Surgery


Endoscopic lumbar discectomy, cost effective operative procedure at tertiary care centre


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Author Details: Jayprakash V. Modi, Ashish D. Yadav, Kaushal R. Patel, Shardul S. Soman

Volume : 2

Issue : 2

Online ISSN : 2395-1362

Print ISSN : 2395-1354

Article First Page : 165

Article End Page : 169


Abstract

Study design: Retrospective study
Background: Endoscopic lumbar discectomy using endoscopic tubular retractor system(METRx-MD) are considered popular minimally invasive surgery (MIS) methods for the treatment of lumbar disc herniation. Our main aim is to apread the benefits related endoscopic technique for lumbar disc herniation at tertiary care centre through which we can reduce the huge patient’s workload and patients are also getting best treatment for their respective disease through minimal invasive surgery.
Objective: To evaluate the effectiveness of Endoscopic Lumbar Discectomy as cost effective procedure at tertiary care center where there is huge patient’s workload.
Methods: It is a retrospective study of 40 patients were operated during the period between August-2013 to August-2015,at B.J Medical college, civil hospital, ahmedabad out of which 29 were males and 11 females between age group of 17 and 72 years and compared with the standard results of open mini incision discectomy.
Inclusion criteria: Single level lumbar disc herniation, Unilateral or bilateral radiculopathy.
Exclusion criteria: Multiple level disc bulge, Presence of spinal instability, Presence of gross spinal deformity

Results:

·         In our study out of 40 patients, 29(72.5%) were males and 11(27.5%) were females.

·         22 (55%) patients had L4-L5 level disc herniation while 18 (45%) patients had L5-S1 level disc herniation.

·         Out of 40 patients, only 3 patients presented with complications.

·         Complications observed in our study were dural tear, infection and recurrence of radiculopathy.

·         Immediate post-op improvement of VAS, oswestry and SF-12 score was noted in all patients.

Conclusion and Summary: Endoscopic Discectomy is a minimally invasive spine surgery which has better outcome (as compared with standard mini incision discectomy) in terms of:

·         Better Pain Relief

·         Decreased Intra-op Blood Loss

·         Lesser duration of operation

·         Earlier Mobilization

·         cosmesis

·         Decreased duration of hospitalization

·         Decreased rate of infection

·         Cost effective in a government setup in low income country

·         Complications observed in our study can be attributed to the longer learning curve for the procedure endoscopic discectomy.

However long term outcomes for pain relief and complications need to be studied in detail.

Key Word:
Endoscopic lumbar discectomy, Lumbar disc herniation, Minimal invasive spine surgery, Cost effectiveness