Clinical outcomes of microscopic lumbar discectomy with tubular retractor

Background: The conception of microscopic lumbar discectomy with tubular retractor (MDT) was first introduced in 1997. In Thailand this procedure and its clinical outcomes have not been described. Objective: To describe the MDT technique for treatment of lumbar disc herniation and to report clinical outcomes. Material and Method: A prospective study involving 20 consecutive cases with lumbar disc herniation treated by MDT was conducted. The SF-36 was used to quantify the clinical results. The degree of pain was also measured by visual analog scale (VAS). The outcomes were measured pre-operatively, and then 1 month and 1 year after the surgery. Results: There was dramatic improvement of mean SF-36 and VAS at 1 month and 1 year postoperatively, as compared to pre-operative status. The average length of hospital stay was 4 days. The time to return to work or normal activity was 37.5 days. The average operative blood loss was 50 ml and the intravenous narcotic use was 9/20 (45%). Conclusion: MDT is effective with fine long-term outcomes in treating lumbar disc herniation when compared with standard open microdiscectomy. It allows smaller incisions and less tissue trauma. Strict adherence to pre-operative patient-selection criteria should ensure optimal postoperative outcomes.