Clinical outcomes of tubular microdiscectomy with 18mm diameter tubular retractor for lumbar disc herniation

Introduction: Tubular microdiscectomy is one of the minimally invasive techniques for spine surgery. This prospective study aims to evaluate the clinical outcomes of using a tubular microdiscectomy with an 18 mm dilator for the treatment of lumbar disc herniation over a 2-year period. Methods: A prospective observational study of 57 patients who had undergone a first-time, single-level lumbar discectomy presented with single-sided radiculopathy with or without backache was done. Perioperative and postoperative results were assessed by documenting operative time, estimated blood loss, length of stay, rate of wound infection, neurological deficits in post-op period, rate of cerebrospinal fluid leak and resumption of work. Pain assessment was done with VAS score at admission, at discharge and in follow up. Results: A total of 57 patients were included in the study. The average duration of surgery was 64 minutes. The average duration from surgery to discharge was 35.5 hours. The average time for complete resolution of radicular symptoms was 8.5 days. The median time for return to work was 20 days. Two patients experienced cerebrospinal fluid (CSF) leak due to inadvertent durotomy. The mean Visual Analog Scale (VAS) value at admission was 9.5087, which significantly reduced to 1.49 at discharge. Follow-up assessments at 15 days, 1 month, 3 months and 1 year revealed sustained improvements in clinical outcomes. Conclusion: Tubular microdiscectomy with an 18 mm dilator demonstrates favourable clinical outcomes for patients having single-level lumbar disc prolapse intervertebral disc causing radiculopathy and low backache, less blood loss intraoperatively, small scar, lesser hospital stay and early return to work.