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PubMed · 8151439

Percutaneous discectomy.

Abstract

1. In patients with symptomatic lumbar disc herniations contained within the interspace, the percutaneous automated discectomy is a reasonable option to open operative procedures. The results appear to be comparable in either case. 2. The procedure is done under local anesthesia, thus avoiding a general anesthetic, and has a shorter and less painful postoperative recovery period. 3. The complications and morbidity from the percutaneous technique appear to be significantly less than the open surgical techniques. 4. Proper selection of surgical candidates is extremely important in any surgical approach to the treatment of lumbar degenerative disc disease. Patients who have had a prior lumbar surgery (or "redo" cases) do not appear to do well with percutaneous discectomy. 5. As demonstrated in many other studies, the workers' compensation/liability patients did not fare as well as "standard" patients. 6. Since the original study, we have performed an additional 50 automated percutaneous discectomies and 52 laser discectomies (totaling 212 cases in all). 7. Although the sample size is small, and our experience is limited, patients treated with laser discectomy appear to be experiencing a higher percentage of favorable results than patients treated with automated percutaneous discectomy.

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BibTeXRIS

D L Polk. 1994. Percutaneous discectomy.. https://pubmed.ncbi.nlm.nih.gov/8151439/

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Lumbar microdiscectomy and microendoscopic discectomy.

Lumbar microdiscectomy, which relies on the operating microscope for visualization, was first described in the late 1970s. This operation is considered the gold standard procedure for patients who require surgery for symptomatic lumbar disc herniation causing radiculopathy that has not improved with conservative measures. A new approach to the management of symptomatic lumbar disc herniation, microendoscopic discectomy, was introduced in 1997. This operation utilizes a tubular retractor system and a microendoscope for visualization rather than the operating microscope. As it is a new procedure, long-term outcomes have not yet been established for this operation. However, recent literature suggests that microendoscopic discectomy may be as effective as the traditional lumbar microdiscectomy in relieving radiculopathy. This article describes the operative techniques and outcomes reported in the literature for both lumbar microdiscectomy and microendoscopic discectomy.

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