MATSUDA et al : Clinical results of microdiscectomy for lumbar disc herniation

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  • MATSUDA Kiyotsugu
    神戸大学医学部整形外科学教室〔〒650-0017 〒神戸市中央区楠町7-5-2〕
  • 土井田 稔
    神戸大学医学部整形外科学教室〔〒650-0017 〒神戸市中央区楠町7-5-2〕
  • 丸井 隆
    神戸大学医学部整形外科学教室〔〒650-0017 〒神戸市中央区楠町7-5-2〕
  • 水野 耕作
    神戸大学医学部整形外科学教室〔〒650-0017 〒神戸市中央区楠町7-5-2〕

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  • 顕微鏡視下腰椎椎間板ヘルニア摘出術の臨床的検討
  • ケンビキョウシ カ ヨウツイ ツイカンバン ヘルニア テキシュツジュツ ノ リンショウテキ ケントウ

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Abstract

Microdiscectomy for the lumbar disc herniation (LDH) is being done more frequently and numerous studies have shown the results to be just as acceptable as a standard (open) discectomy. We compared clinical results of microdiscectomy versus standard (open) discectomy. Patients and Methods: Microdiscectomies were performed on twenty patients (Group A: mean age 44.4 yrs.), and standard (open) discectomy were performed on twenty patients (Group B: mean age 37.3 yrs.). Clinical results were evaluated by using the Japanese Orthopaedic Association scoring system (JOA score) plus looking at and scoring patient outcomes based on such variables as operation time, blood loss, duration of bed rest and the degree of low back pain at follow up. Results and Discussion: JOA score, mean surgical time and blood loss were not statistically different between patients in Group A and Group B. The duration of bed rest of the patients in Group A was significantly shorter than the duration of bed rest for patients in Group B. Patients in Group A reported less severe low back pain than patients in Group B. Microdiscectomy can preserve the paravertebral muscle better than the standard (open) discectomy. The preservation the soft tissue might lead to the better surgical results and earlier return to normal levels of daily activity. Conclusion: Our study points to better clinical outcomes for patients treated by microdiscectomy than for patients treated by the standard (open) discectomy, particularly with regard to quicker recovery and reduced levels of low back pain at follow up.

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