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Long-term Outcome After Microendoscopic Diskectomy for Lumbar Disk Herniation: A Prospective Clinical Study With a 5-Year Follow-up

Casal-Moro, Roberto MD*; Castro-Menéndez, Manuel MD, PhD‡; Hernández-Blanco, Moisés MD*; Bravo-Ricoy, Jose A MD§; Jorge-Barreiro, Francisco J MD, PhD¶

doi: 10.1227/NEU.0b013e31820cd16a
Research-Human-Clinical Studies: Editor's Choice

BACKGROUND: Several authors have reported results obtained with the microendoscopic diskectomy (MED) technique, but the long-term outcome has not been described. This report summarizes our clinical experience with the lumbar MED technique with a long-term follow-up period.

OBJECTIVE: To evaluate the efficacy of the MED for lumbar disk herniation and to report long-term outcome and complications (5-year follow-up).

METHODS: One hundred twenty consecutive patients with lumbar disk herniation were treated with the METRx system.We included all types of lumbar herniated disks: contained, not contained, foraminal, and migrated disk herniations. The results were evaluated with the Visual Analog Scale (VAS) pain score, Oswestry Disability Index score, patient satisfaction questionnaire, and modified Macnab criteria.

RESULTS: The average age of patients was 41 years; 65 were men and 55 were women. The most commonly affected level was L5-S1 (54.2%). The follow-up time after surgery was 5 years in all cases. We obtained good or excellent results in 75% of patients and regular results in 18%. Good subjective satisfaction was observed with surgery in 92% of patients. The mean decrease in the Oswestry Disability Index score was 52.8 ± 21.6; the mean decrease in leg VAS score was 6.1 ± 2.3; and the mean decrease in lumbar VAS score was 1.9 ± 3.3. Adjusted mean differences were statistically significant in all cases (P < .05).

CONCLUSION: MED not only reduces the incision, tissue damage, and postoperative period of incapacity but also offers long-term results comparable to those of conventional techniques.

*Department of Orthopaedics, University Hospital of Vigo, Vigo, Spain; Departments of ‡Orthopaedics, and §Preventive Medicine and Public Health, Monforte de Lemos Hospital, Lugo, Spain; ¶University Hospital of Santiago de Compostela, Santiago de Compostela, Spain

Received, March 22, 2010.

Accepted, November 1, 2010.

Correspondence: Roberto Casal-Moro, MD, Department of Orthopaedics, Meixoeiro Hospital (University Hospital of Vigo), C/Meixoeiro s/n, 36200 Vigo (Pontevedra), Spain. E-mail:

Copyright © by the Congress of Neurological Surgeons