title: Comparison of safety and efficiency of microendoscopic discectomy with automatic nerve retractor and with nerve hook.
abstract: This study compares the safety and efficiency of two techniques in microendoscopic discectomy (MED) for lumbar disc herniation. The two techniques are MED with automatic nerve retractor and MED with nerve hook which had been widely used for many years. The former involves a newly developed MED device which contains three parts to protect nerve roots during operation. Four hundred and twenty-eight patients underwent MED treatments between October 2010 and September 2015 were recruited and randomized to either intraoperative utilization of automatic nerve retractor (n= 315, group A) or application of nerve hook during surgery (n= 113, group B). Operation time and intraoperative bleeding volume were evaluated. Simultaneously, Visual Analogue Scales (VAS) and muscle strength grading were performed preoperatively, and 1, 2, 3 days, 1, 2 weeks, 3 and 6 months postoperatively. No dramatic difference of pain intensity was observed between the two groups before surgery and 6 months after surgery (P> 0.05). The operation time was shorter in group A (30.30 ± 1.89 min) than that in group B (59.41 ± 3.25 min). Group A (67.83 ± 13.14 ml) experienced a significant decrease in the amount of blood loss volume when compared with group B (100.04 ± 15.10 ml). There were remarkable differences of VAS score and muscle strength grading after postoperative 1, 2, 3 days, 1, 2 weeks and 3 months between both groups (P≤ 0.05). MED with automatic nerve retractor effectively shortened operation time, decreased the amount of bleeding, down-regulated the incidence of nerve traction injury.
authors.affiliation: The Second Affiliated Hospital, Inner Mongolia Medical University, Hohhot 010030, China.
authors.forename: He-Ping
authors.initials: HP
authors.lastname: Yin
authors.affiliation: The Second Affiliated Hospital, Inner Mongolia Medical University, Hohhot 010030, China.
authors.forename: Yu-Peng
authors.initials: YP
authors.lastname: Wang
authors.affiliation: The Second Affiliated Hospital, Inner Mongolia Medical University, Hohhot 010030, China.
authors.forename: Zhi-Ye
authors.initials: ZY
authors.lastname: Qiu
authors.affiliation: The Second Affiliated Hospital, Inner Mongolia Medical University, Hohhot 010030, China.
authors.forename: Zhi-Cai
authors.initials: ZC
authors.lastname: Du
authors.affiliation: The Second Affiliated Hospital, Inner Mongolia Medical University, Hohhot 010030, China.
authors.forename: Yi-Min
authors.initials: YM
authors.lastname: Wu
authors.affiliation: The Second Affiliated Hospital, Inner Mongolia Medical University, Hohhot 010030, China.
authors.forename: Shu-Wen
authors.initials: SW
authors.lastname: Li
keywords: automatic nerve retractor; microendoscopic discectomy; minimally invasive lumbar discectomy; nerve hook