Microendoscopic discectomy with single B-Twin implantation for lumbar disc herniation

English Keywords:Lumbar disc herniation  Spine fusion  Microendoscopic discectomy  B-Twin

English Abstract:

  【Abstract】 Objective：To investigate the clinical effect of microendoscopic discectomy（MED） with single B-Twin implantation for lumbar disc herniation.Method：21 cases with lumbar intervertebral disc herniation undergoing posterior MED with single B-Twin implantation between June 2005 and June 2008 were reviewed retrospectively.All patients complained of lower back pain and unilateral lower limbs pain.The involved levels included L3/4 in 1 patient，L4/5 in 12 patients and L5/S1 in 8 patients.The preoperative disc height was 7.73±1.61mm，the degree of instability scored by the Oswestry disability index（ODI） was 31-45（37.5±6.9）.The ODI score and disc height at 1 month after operation and the latest follow-up together with instrument displacement and bony union were reviewed.Result：The mean duration of operation was 1.7h（1.5-2.1h） with blood loss of 75-190ml（mean，90ml）.No neurovascular complications were noted.All 21 patients were followed-up from 6 months to 3 years and no severe complications such as deep infection，hematoma，nerve injury and instrument displacement were found.The ODI score at 1 month postoperatively was 10-19（mean 15.5±4.2），which showed significant difference compared with that of preoperative（P<0.01），the ODI score at final follow-up was 7-12（mean 9.6±3.8），which showed significant difference as compared with the 1 month postoperative counterpart（P<0.01）.The one month postoperative disc height was 10.23±1.49mm，with significant difference compared with the preoperative one（P<0.01），and the finalt follow-up dissc height was 7.75±1.74mm，with significant difference compared with the 1 month postoperative one（P<0.01），but no significant difference was noted as compared to the preoperative one（P＞0.05）.All the patients achieved solid bony union without instrument displacement at final follow-up.Conclusion：MED with single B-Twin implantation for lumbar disc herniation is reliable and minimal invasive.