gms | German Medical Science

65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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Outcome of conventional lumbar microdiscectomy compared to microdiscectomy via minimal invasive microtubuluar access (METRx): Preliminary data of a single center RCT

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  • Bogdan Pintea - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Bonn
  • Christian-Andreas Müller - Klinik für Neurochirurgie, Universitätsklinikum Aachen, Aachen
  • Matthias Geiger - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Bonn; Klinik für Neurochirurgie, Universitätsklinikum Aachen, Aachen
  • Mohammed Banat - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Bonn
  • Martin Podlogar - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Bonn
  • Sami Ridwan - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Bonn
  • Christian Blume - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Bonn; Klinik für Neurochirurgie, Universitätsklinikum Aachen, Aachen
  • Hartmut Vatter - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Bonn
  • Rudolf Andreas Kristof - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Bonn

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMI.01.01

doi: 10.3205/14dgnc262, urn:nbn:de:0183-14dgnc2626

Published: May 13, 2014

© 2014 Pintea et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: To compare the results of lumbar microdisectomy via tubular access with those of microdiscectomy via conventional access.

Method: In a single centre randomized control trial, we compare the results of the tubular with those of the conventional access for microdiscectomy by following parameters: duration of surgery, fluoroscopy dose-area product, perioperative complications, duration of in hospital stay, postoperative back and leg pain (assess by VAS and Prolo Functional Score) and economic status (Prolo economic score).

Results: At present we enrolled 92 patient in the conventional and 93 in the microtubular access arm. The surgery duration (80 min. vs 92 min, p=0,0039) and the fluoroscopy dose-area product (0,6 Gy/cm2 vs 2,4 Gy/cm2, p=0,0001) were significantly longer in the patient group with tubular access. No statistical significant differences between the two patient groups were found for: overall surgical complication rate (METRx 5% vs conventional 3%, p=0,7), postoperative in hospital stay (METRx 6 days vs conventional 6 day, p=0,3), back pain at discharge and 3 months postoperatively (VAS: METRx 2,6 and 2,9 vs conventional 2,8 and 3,1, p=0,5 and p=0,8), leg pain at discharge and 3 months postoperatively (VAS: METRx 1,8 and 2,4 vs conventional 1,9 and 2,7, p=0,9 and p=0,5), Prolo functional score at discharge and 3 month postoperatively (METRx 2,9 and 3,3 vs conventional 2,9 and 3,5, p=0,9 and p=0,3), Prolo economic score at discharge and 3 month postoperatively (METRx 2,8 and 3,5 vs conventional 2,8 and 3,3, p=0,8 and p=0,2) and beginning of reintegration into employment (METRx 2 months and conventional 2 months, p=0,7).

Conclusions: As far as assessable by our preliminary results, the microtubular access for microdisectomy does not provide advantages over the conventional access for lumbar discectomy. However, the final results of the study have to be awaited.