Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Spine
Abstract number: 26102
MICRO ENDOSCOPIC DISCECTOMY UTILIZING PROGRESSIVE LOCAL
ANESTHESIA AND NERVE ROOT BLOCK
Masaru KOBAYASHI
Takamatsu Redcross Hospital, Kagawa prefecture (JAPAN)
Introduction: Microendoscopic discectomy (MED) is one of the minimally invasive
endoscopic procedures for lumber nerve decompression. We started MED using
METRx system under Local Anesthesia (LA) and nerve root block since 2008. We
evaluate and report its clinical outcome of 13 cases. Surgical procedures: Tubular
retractor was set after skin; paravertebral muscles and periosteum above lamina
were anesthetized with 1% xylocaine containing epinephrine. Operations in epidural
space needed additional infiltration of anesthetic, whereas additional xylocaine was
not needed during laminotomy. Discectomy could be performed conventionally after
nerve root block. Methods: Clinical outcomes of LA group were compared with that of
22 cases under GA. And patient's satisfaction rate after operation and complications
were evaluated. Results: There were no significant differences between two groups
in clinical outcomes; operative time (LA:87.6±24.2, GA:74.2±16.1min.) recovery rate
of JOA score (LA:66.0±16.7, GA:69.7±17.8%) and decreasing rate of VAS score
(LA:73.8±22.6, GA:84.9±19.0%). All patients treated under LA were satisfied with its
clinical outcomes and 12 patients answered these surgical procedures were
acceptable for them. Bradycardia as only complication occurred in 4cases.
Conclusions: Our trial revealed this procedure could be performed with no technical
problem and no major complication. This procedure may be able to reduce the stress
of the perioperative patients further and become new minimally invasive strategy of
LDH.
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