Microendoscopic Discectomy for Lumbar Disc Herniation: Report of the Surgical Technique

Abstract

Microendoscopic discectomy (MED) has become popular recently for treating lumbar disc herniation (LDH). The technique involves a shorter incision and considerably less tissue trauma than traditional open-surgery techniques. However, there is a steep learning curve to performing this procedure efficiently and safely, due to the very limited working space within the (19 mm external-diameter) 18 mm internal-diameter of the tubular retractor. Here we describe in detail the MED technique for LDH using the METRx Microscopic Discectomy (MD) system (Medtronic Sofamor Danek, Memphis, TN). This system offers variable tubular retractor lengths and increased available working space within the tubular retractor. The potential complications however are similar whether using a standard 93 mm length retractor or other lengths in this system, but the increased diameter offers some advantages in the working space.