microsurgical discectomy

microsurgical discectomy

Surgery of a herniated intervertebral disc without prior exploration of the vertebral body, which reduces the risk of failed disc syndrome as there is minimal excision of bone and epidural fat and minimal nerve root adhesion.
 
Indications
Cauda equina syndrome, herniated lumbar disc, sciatica due to herniated disc.

Pros
Less soft-tissue trauma, shorter hospital stay; may be performed as outpatient procedure under local anaesthesia. 

Cons
86% success rate for relief of leg pain (vs up to 98% for standard laminotomy-discectomy).

Potential complications
Dural tears, nerve root damage, reherniation of same disc, residual disc fragments with persistent pain.
References in periodicals archive ?
(32) conducted a prospective controlled study of 200 patients who were randomized to either full-endoscopic discectomy (transforaminal or interlaminar) or open microsurgical discectomy with 2-year follow-up.
[5.] Caspar W, Campbell B, Barbier DD, Kretschmmer R, Gotfried Y The Caspar microsurgical discectomy and comparison with a conventional standard lumbar disc procedure.
Patient satisfaction with outpatient lumbar microsurgical discectomy: a qualitative study.
Huang, "Cauda equina incarceration secondary to dural tears after lumbar microsurgical discectomy," Formosan Journal of Surgery, vol.
In cases like ours, sequestration was purely anterior-to-posterior and, in our experience, the standard microsurgical discectomy technique has to be slightly modified in order to increase the postoperative functional improvement: a wide unilateral arthrectomy and partial unilateral interlaminectomy with exposure of the dural sac, "exiting" and "transiting" nerve root, appears to be mandatory to avoid:
She was only two years younger than me (yes, I'm 68) and had been her now retired neurosurgeon husband's anaesthetist years ago, when this operation (anterior microsurgical discectomy) was first performed in Cyprus.