title: Long-Term Outcome of Microendoscopic Diskectomy for Lumbar Disk Herniation. A Clinical Study of Consecutive 112 Cases with More than 5-Year Follow-Up.
abstract: BackgroundClinical results and recurrence rate after microendoscopic diskectomy (MED) with long-term follow-up is still unclear, in spite of its relatively long history.Materials and MethodsA total of 112 who underwent MED participated in this study. Operative time, blood loss, serum C-reactive protein (CRP), creatine kinase (CK), and visual analog scale (VAS) were evaluated as indexes of surgical invasiveness. The 36-Item Short Form Survey Instrument (SF-36), Japanese Orthopaedic Association (JOA) score, patient satisfaction, and recurrence were also evaluated with a follow-up of at least 5 years.ResultsThe mean operative time was 86.7 minutes, and the mean blood loss was 35.7 mL. The mean CRP on postoperative day 3 and CK on the first postoperative day was 0.72 mg/dL and 224.6 IU/L, respectively, and VAS to assess surgical site pain on the first postoperative day was 24.9 mm on average. The improvement rate in the JOA score was 68.7%. The physical component summary of SF-36 in norm-based scoring was improved from 23.4 to 48.6. Overall, 90.8% of patients evaluated their response to the surgery as extremely satisfied or satisfied. The recurrence rate was 10.5%, and reoperation was performed in 7.9% of patients.ConclusionsMED is a technique that offers both reduced invasiveness and good long-term clinical results.
authors.affiliation: Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan.
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Yoshimoto
authors.affiliation: Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Iesato
authors.affiliation: Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Terashima
authors.affiliation: Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan.
authors.forename: Katsumasa
authors.initials: K
authors.lastname: Tanimoto
authors.affiliation: Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan.
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Takebayashi
authors.affiliation: Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Yamashita
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D003402:Creatine Kinase / Q000097:blood; D017586:Diskectomy / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010147:Pain Measurement; D017060:Patient Satisfaction; D011184:Postoperative Period; D012008:Recurrence; D012086:Reoperation; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein; D003402:Creatine Kinase