title: Microendoscopic discectomy for far lateral lumbar disk herniation: less surgical invasiveness and minimum 2-year follow-up results.
abstract: METHODS
  A retrospective review of data collected prospectively on 24 consecutive patients who underwent microendoscopic discectomy (MED) for far lateral lumbar disk herniation.
  
  
  OBJECTIVE
  To evaluate the level of surgical invasiveness of the procedure and clinical results with a follow-up of at least 2 years.
  
  
  BACKGROUND
  To the best of our knowledge, there have only been 2 small-size and short-term clinical studies reporting the feasibility of MED for far lateral lumbar disk herniation, despite its relatively long history. Moreover, these 2 articles did not include detailed evaluations of surgical invasiveness and did not comprise any cases with disk herniation at L5-S1, which should account for a considerable proportion of cases.
  
  
  METHODS
  Twenty-four consecutive patients, including L5-S1 patients, who underwent MED for far lateral lumbar disk herniation participated in this study. Ninety-three consecutive patients with intracanalicular disk herniation, who underwent MED also participated as control subjects. Operative time, intraoperative blood loss, serum C-reactive protein and creatine kinase, visual analog scale, and Japanese Orthopaedic Association score were evaluated.
  
  
  RESULTS
  The procedure was successfully performed in all cases. The operative time in patients with far lateral disk herniation (143.9 min) was significantly longer than in patients with intracanalicular disk herniation (90.2 min) (P<0.01). There were no differences between the groups in terms of intraoperative blood loss (39.6 and 40.4 mL, respectively), serum C-reactive protein level on postoperative day 3 (0.71 and 0.73 mg/dL), serum creatine kinase level on postoperative day 1 (161.8 and 225.7 IU/L), visual analog scale scores to assess surgical site pain on the first postoperative day (19.4 and 24.0 mm), or improvement rate in Japanese Orthopaedic Association score at final follow-up (76.0% and 77.0%).
  
  
  CONCLUSIONS
  MED is a well-balanced technique which offers both reduced invasiveness and good clinical results without sacrificing reliability.
authors: Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors: Mitsunori
authors: M
authors: Yoshimoto
authors: Takehito
authors: T
authors: Iwase
authors: Tsuneo
authors: T
authors: Takebayashi
authors: Kazunori
authors: K
authors: Ida
authors: Toshihiko
authors: T
authors: Yamashita
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003710:Demography; D017586:Diskectomy / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D017116:Low Back Pain / Q000601:surgery; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D015203:Reproducibility of Results; D055815:Young Adult