Safety analysis of microscope-assisted lumbar interbody decompression, fusion and internal fixation in the treatment of recurrent lumbar disc herniation

English Keywords:Lumbar disc herniation  Microscope  Revision surgery

English Abstract:

  【Abstract】 Objectives: To analyze the safety of the assistance of microscope in lumbar interbody decompression, fusion and internal fixation in the treatment of recurrent lumbar disc herniation. Methods: Retrospective analysis was made on 73 patients recurred lumbar disc herniation after percutaneous endoscopic lumbar discectomy(PELD) and underwent a revision surgery of single-segment lumbar decompression and fusion in our hospital from January 1, 2020 to April 1, 2022. Among the patients, 42 received microscope-assisted operation(microscope group), including 31 males and 11 females, aged 53.4±16.4 years; the other 31 received an operation without microscope assistance(conventional group), including 18 males and 13 females, aged 49.6±11.4 years. There were no significant differences between the two groups in general data such as gender, age and BMI(P>0.05). Data such as the surgical approach and surgical segment of initial PELD, and operative time, intraoperative bleeding volume, total postoperative drainage volume, postoperative length of stay, dural tears, nerve injury and superficial infection of the revision surgery were collected and compared between the two groups. Results: All the operations were successful. In the microscope group, the operative time was 168.0±33.1min, intraoperative bleeding volume was 125.0±40.2mL, total drainage volume was 379.6±220.6mL and postoperative length of stay was 5.2±1.3d, and dural tears occurred in 2 patients, none nerve injury or superficial wound infection was found. In the conventional group, the operative time was 155.8±29.4min, intraoperative bleeding volume was 133.9±59.7mL, total drainage volume was 452.2±464.5mL, and postoperative length of stay was 5.0±1.7d, and dural tears occurred in 4 patients, nerve injury was noticed in 1 patient, and none superficial wound infection was found. There was no statistical difference in perioperative and complication data between the two groups(P>0.05). Conclusions: Microscope does not increase the operative time, intraoperative bleeding volume, postoperative length of stay, and the rate of infection, dural tears and nerve injury in the revision surgery after PELD.