lumbar disc herniation BESS Biportal endoscopic spine surgery MD microscopic lumbar discectomy LDH lumbar disc herniation
Conditions
Interventions
BESS for lumbar discectomy
After general anesthesia,
the patients were positioned prone in a Wilson spinal frame. The operated level was identified with image intensifier and marked with surgical pen for the spinous process,
disc level and interlaminar space. The portal landmarks were at the lower edge of lower lamina of the upper spine and upper margin of upper lamina of the lower spine about 2 centimeters apart just lat
set the level to 2. The water pump was set to 30-
50 mmHg and the irrigation flow was through the skin portal. Unilateral laminotomy was performed with high speed blur and Kerrison rongeur,
ligamentum flavum was remove and Dural sac was exposed. For disc herniation (Figure 2.),
the traversing nerve root was identified and protected with Penfield or semi tubular retractor,
Discectomy was done with knife,
curettage. Annuloplasty was done by coagulation.
,Microscopic lumbar discectomy (MD)
The surgical technique was performed under general anesthesia in a prone position on a radiolucent table under fl
spinous process of the upper vertebra to the spinous process of the lower vertebra at the involved level. After creating a 3-
5 cm incision in the midline,
the fascia was dissected to the lateral edge of the inferior articular fac
Experimental Procedure/Surgery,Active Comparator Procedure/Surgery
Biportal endoscopic spine surgery for lumbar discectomy,Microscopic lumbar discectomy
Sponsors
Khon Kaen hospital
Khon Kaen hospital
Eligibility
Sex/Gender
All
Age
18 Years to 60 Years
Inclusion criteria
Inclusion criteria: 1. Single level lumbar HNP patient who has 2. Neurologic claudication or radicular leg pain referring to lumbar disc herniation 3. Patient aged more than 18 years and less than 60 years old 4. MRI show single lumbar disc herniation 5. Failure of conservative treatment at least 6 weeks or severe pain not responded to conservative treatment
Exclusion criteria
Exclusion criteria: 1. Pregnancy or lactation 2. Previous history of lumbar surgery 3. Patient refuse to do surgery. 4. Medical unfit for operation 5. Spondylolisthesis more than Grade I Mayerding
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| VAS score for post-operative surgical site pain at PACU, 12, 24, 36, 48 and 72 hrs post-op VAS ,Morphine usage post-operative milligram | — |
Secondary
| Measure | Time frame |
|---|---|
| VAS score for back and leg pain preop and post op at 2, 12 and 24 weeks VAS,ODI score pre-op, 2 wks, 12 wks and 24 wks post-op ODI score,Macnab criteria for patient satisfaction post-op 2 weeks, 12 weeks and 24 weeks Macnab criteria ,CRP pre-op and post-op at 24 and 72 hours blood for CRP Level ,CPK pre-op and post-op at 24 and 72 hours blood for CPK level | — |
Contacts
Public ContactThanit Foocharoen
Khon Kaen hospital
Outcome results
None listed