Abstract
Purpose: The advent of lapaoscopic disectomy has made it possible to cure discal herniation with minimal trauma and no limitations on indications. We have adopted the technique described by J. Destandau since June 1998. The purpose of this work was to report our early results.
Material and methods: Forty patients were included in a period from June 1998 to August 2000. There were 24 men and 16 women, mean age 43 years (24–78). Eleven patients had an associated stenosis of the spinal canal. Accelerated rehabilitation was employed. Sitting and driving were allowed early.
Results: Mean follow-up was 13 months (2–27 months). Mean operative time was 63 minutes (30–150 min). Mean hospital stay was 3.92 days (2–10). There were 29 patients without stenosis of the lumbar canal. In this subgroup, outcome was excellent in 69%, good in 21% (six patients), fair in 3% (one patient), and poor in 7% (two patients). For the PROLO score, three patients were who were retreated were not included in the analysis. Outcome was excellent in 73% (19 patients), good in 12% (three patients), fair in 12% (three patients, and poor in 4% (one patient). In patients with lumbar canal stenosis, (eleven patients), three were reoperated for wider decompression; there was no haematoma. One patient was reoperated for deep infection. For the other patients the WADDELL score was excellent in five and good; in two the PROLO score was excellent in six and poor in one.
Discussion: The technique favoured a narrow approach. Shorter exposure preserved the anatomy, but for the three patients with an associated stenosis, reoperation was necessary for decompression. For the cases without complications, we noticed that recovery was very rapid, a finding which is exceptional with the conventional technique.
Conclusion: Our early experience with this technique has demonstrated that laparoscopic discectomy is feasible and safe. An associated stenosis is a limitation; we recommend systematic decompression in association with the discectomy.
The abstracts were prepared by Pr. Jean-Pierre Courpied (General Secretary). Correspondence should be addressed to him at SOFCOT, 56 rue Boissonade, 75014 Paris, France
