Bowel Injury following Lumbar Discectomy using Minimally Invasive Retractors

Prevalence of symptomatic lumbar disc herniation is 1-3% in the adult population. When conservative therapy (e.g., physiotherapy, anti-inflammatories, epidural injections, etc.) fails, open microsurgical discectomy is regarded as the treatment of choice.With this procedure, the incidence of injury to visceral bowel is reported to be 3.8 per 10,000 cases. With the recent advent of tubular retractor systems, an increasing number of surgeons are using this minimally invasive procedure to replace traditional open microsurgical discectomy. The advantages include a smaller skin incision and a muscle splitting rather than muscle incising technique. As a result post-operative pain, blood loss and length of hospital stay may decrease significantly. Multiple studies have compared the two surgical techniques with regards to their clinical outcomes. The results of these studies reveal equal if not superior clinical outcomes with the minimally invasive technique. Despite the success of the minimally invasive microdiscectomy, none of the studies reported any intraoperative complications using this novel technique.