[Accurate nerve orientation before micro endoscopic discectomy for lumber disc prolapse].
OBJECTIVE
To assess the safety and efficiency of using computerized tomography myelography (CTM) and computerized tomography discography (CTD) to accurately orientate the nerve before micro endoscopic discectomy (MED).


METHODS
Eighty-seven patients with lumber disc prolapse, 54 males and 33 females, aged 35.6 +/- 3.0, underwent MED. Before operation, 85 patients underwent CTM, 11 patients underwent CTD, and 2 were treated with nerve root opacification and blockade. The effects, including the rate of improved JOA score (RIS), numerical analogous pain score (NAPS) of low back, Odom's standard, blood loss during operation, start walking time, etc. were observed.


RESULTS
The JOA score was 18.2 +/- 3.3 before operation, and increased to 23.8 +/- 4.6 during the follow-up, with a JOA improvement rate of 58.7% +/- 4.2%. According to the Odom's standard, the outcome was excellent in 59 cases, good in 26 cases, OK in 3 cases, and poor in 1 case, with an excellence rate of 95.5%. The value of NAPS was 1.8 +/- 0.4 before operation, not significantly different from that during follow-up (1.7 +/- 0.3, P = 0.607). The average start walking time after operation was (2.38 +/- 0.21) days, the average recovery time was (12.1 +/- 2.2) days, the incision size was (1.86 +/- 0.04) cm, the surgical time was (72.2 +/- 12.4) min, and the average blood loss during operation was (47.5 +/- 4.6) ml.


CONCLUSIONS
Using CTM and CTD to accurately orientate the diseased disc and nerve root before MED decreases the possibility of nerve damage, operation time and blood loss during operation, and improves the outcomes, so it is recommendable.
Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing 100035, China.
Qin
Q
Li
Wei
W
Tian
Bo
B
Liu
Lin
L
Hu
Yong-qing
YQ
Wang
Ning
N
Yuan
D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D017586:Diskectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000601:surgery*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D009192:Myelography / Q000379:methods; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016896:Treatment Outcome