title: [The clinical comparison of microendoscopic lumbar diskectomy with and without preservation of the ligamentum flavum].
abstract: OBJECTIVE
  To discuss the surgical technique, indication and the clinical effects of the Microscope Endoscopic Tubular Retractor System (METRx) for microendoscopic lumbar diskectomy with the preservation of the ligamentum flavum.
  
  
  METHODS
  Two hundred and eleven patients underwent single-segment METRx, with ligamentum flavum preservation in 65 patients (Group A), and without preservation in 146 patients (Group B). The two groups were compared clinically. All the patients suffered from low back pain and radicular syndrome to some extent, and the diagnosis was affirmed by CT and/or MRI. After exposed the interlaminar space regularly, the superior, inferior and lateral edge of the ligamentum flavum was released, the 3-sided dissociative ligament pacth was retracted medially during the spinal manipulation and restored anatomically after disc removal and the decompression of the nerve root.
  
  
  RESULTS
  According to the results of two groups, ligamentum flavum preservation technique was feasible under endoscope and helpful in reducing the scar formation in the spinal canal.
  
  
  CONCLUSIONS
  The ligamentum flavum preservation technique enable the surgeons to preserve the natural barrier. It is feasible to perform METRx, and it is helpful in reducing the epidural fibrosis.
authors.affiliation: Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China. happyzhou@vip.163.com
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhou
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.forename: Tong-wei
authors.initials: TW
authors.lastname: Chu
authors.forename: Wei-dong
authors.initials: WD
authors.lastname: Wang
authors.forename: Wen-jie
authors.initials: WJ
authors.lastname: Zheng
authors.forename: Yong
authors.initials: Y
authors.lastname: Hao
authors.forename: Yong
authors.initials: Y
authors.lastname: Pan
authors.forename: Hai-jun
authors.initials: HJ
authors.lastname: Teng
mesh_terms: D000328:Adult; D001182:Arthroscopy; D017587:Diskectomy, Percutaneous / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D017843:Ligamentum Flavum / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome