Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Spine
Abstract number: 26313
MICROENDOSCOPIC DISCECTOMY UTILIZING PROGRESSIVE LOCAL
ANESTHESIA AND NERVE ROOT BLOCK
Masaru KOBAYASHI
Takamatsu Redcross Hospital, Takamatsu city, 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
22cases under general anesthesia ( 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 only the surgery was
seen as operative complications in 4cases. Conclusions: This study revealed this
procedure could be performed with no technical problem and no major complication.
This procedure may be able to reduce the perioperative stress of the patients further
and become one of the minimally invasive strategies of LDH.
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