Low back pain caused by lumbar disc herniation is a common disorder in spinal surgery clinic. The spinal team in Yantai Affiliated Hospital led by Professor Jiangwei Tan has been attempting to improve the surgical outcome through clinical research. With the goal of rapid recovery, and good postoperative satisfaction, the team made a major breakthrough recently in the treatment of hidden zone lumbar disc herniation. They proposed a novel surgical approach (MELS: Microscopic extra-laminar sequestrectomy), which has been recognized by international peers this year.
Surgical managements of hidden zone disc herniation are risky and controversial because of the difficult exposure of the sequestration. Many techniques have been proposed for this special lumbar disorder including translaminar, interlamina, transpedical and transforaminal endoscopic procedures. These approaches are technically challenging with massive bone defect which could affect the spinal stability. The MELS procedure proposed by Dr. Tan is base on the microscopic surgery is an easy-to-learn surgery with minimal invasion to the spinal elements. The Operative approach goes from the lateral margin of the laminar to the foramen. After finding the exiting nerve root, a probe is employed to hook out the sequestrated discs. Only a small part of the laminar bone needs to be removed and the spinal canalis minimally involved. The research paper was published in BMC Surgery this year and the new technique is expected to be applied in future for more patients.
The spinal team in Yantai Affiliated Hospital has made remarkable achievements in clinical research in recent years. After the publication of Minimally Invasive Surgery for Spinal Tuberculosis in 2020 in the Journal of Orthopaedic Surgery and Research, the team has been accumulating their experience in the treatment of pyogenic spondylitis using antibiotic-loaded calcium sulphate. The research paper was accepted by Musculoskeletal Disorders and will be published in 2021. Their research on spinal trauma, spinal metastatic tumor are also underway and hopefully will have outcome in the near future.
BY: Liu Qing
SOURCE: Yantai Affiliated Hospital of Binzhou Medical University
