Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2020; 8(14): 2942-2949
Published online Jul 26, 2020. doi: 10.12998/wjcc.v8.i14.2942
Comparison of microendoscopic discectomy and open discectomy for single-segment lumbar disc herniation
Jiu-Ya Pang, Fei Tan, Wei-Wei Chen, Cui-Hua Li, Shu-Ping Dou, Jing-Ran Guo, Li-Ying Zhao
Jiu-Ya Pang, Department of Traumatology, The Second Hospital of Tangshan, Tangshan 0630000, Hebei Province, China
Fei Tan, Wei-Wei Chen, Intensive Care Unit, The Second Hospital of Tangshan, Tangshan 0630000, Hebei Province, China
Cui-Hua Li, Department of Nursing, The Second Hospital of Tangshan, Tangshan 0630000, Hebei Province, China
Shu-Ping Dou, Department of Hand Surgery, The Second Hospital of Tangshan, Tangshan 0630000, Hebei Province, China
Jing-Ran Guo, Department of Spinal Surgery, The Second Hospital of Tangshan, Tangshan 0630000, Hebei Province, China
Li-Ying Zhao, Hospital Office, The Second Hospital of Tangshan, Tangshan 0630000, Hebei Province, China
Author contributions: Pang JY and Tan F contributed equally to this article and should be considered as co-first authors; Pang JY, Tan F, and Zhao LY designed this study; Chen WW drafted the work and collected the data; Tan F, Li CH, Dou SP, and Guo JR analyzed and interpreted the data and wrote the article.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of The Second Hospital of Tangshan.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: Dr. Li CH received grants from 2018 Hebei Provincial Key Medical Science Project Plan (20181289), during this study. There are no other financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Cui-Hua Li, MNurs, Associate Chief Nurse, Department of Nursing, The Second Hospital of Tangshan, No. 21, Jianshe Road, Tangshan 0630000, Hebei Province, China. ly80222@163.com
Received: March 22, 2020
Peer-review started: March 22, 2020
First decision: April 14, 2020
Revised: April 24, 2020
Accepted: May 26, 2020
Article in press: May 26, 2020
Published online: July 26, 2020
Processing time: 124 Days and 10.4 Hours
Abstract
BACKGROUND

Lumbar disc herniation is a common disease. Endoscopic treatment may have more advantages than traditional surgery.

AIM

To compare the clinical efficacy and safety of microendoscopic discectomy (MED) and open discectomy with lamina nucleus enucleation in the treatment of single-segment lumbar intervertebral disc herniation.

METHODS

Ninety-six patients who were operated at our hospital were selected for this study. Patients with single-segment lumbar disc herniation were admitted to the hospital from March 2018 to March 2019 and were randomly divided into the observation group and the control group with 48 cases in each group. The former group underwent lumbar discectomy and the latter underwent laparotomy and nucleus pulpectomy. Surgical effects were compared between the two groups.

RESULTS

In terms of surgical indicators, the observation group had a longer operation time, shorter postoperative bedtime and hospital stay, less intraoperative blood loss, and smaller incision length than the control group (P < 0.05). The excellent recovery rate did not differ significantly between the observation group (93.75%) and the control group (91.67%). Visual analogue scale pain scores were significantly lower in the observation group than in the control group at 1 d, 3 d, 1 mo, and 6 mo after surgery (P < 0.05). The incidence of complications was significantly lower in the observation group than in the control group (6.25% vs 22.92%, P < 0.05).

CONCLUSION

Both MED and open discectomy can effectively improve single-segment lumbar disc herniation, but MED is associated with less trauma, less bleeding, and a lower incidence of complications.

Keywords: Lumbar intervertebral discectomy; open discectomy with fenestrated windows; Single-segment lumbar disc herniation; Nerve root; Nucleus pulposus; Pain

Core tip: Microendoscopic discectomy has less trauma, less bleeding, and a lower incidence of complications compared with open discectomy in the treatment of single-segment lumbar disc herniation. Patients were able to get out of bed faster, with reduced pain, and recovered sooner.