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 Table of Contents    
LETTER TO EDITOR  
Year : 2015  |  Volume : 49  |  Issue : 2  |  Page : 262-263
Microendoscopic lumbar discectomy: Technique and results of 188 cases


Department of Neurosurgery, University Medical Center Freiburg, Germany

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Date of Web Publication3-Mar-2015
 

How to cite this article:
Kogias E, Jimenez PF, Hubbe U. Microendoscopic lumbar discectomy: Technique and results of 188 cases. Indian J Orthop 2015;49:262-3

How to cite this URL:
Kogias E, Jimenez PF, Hubbe U. Microendoscopic lumbar discectomy: Technique and results of 188 cases. Indian J Orthop [serial online] 2015 [cited 2020 Feb 21];49:262-3. Available from: http://www.ijoonline.com/text.asp?2015/49/2/262/152551
Sir,

We read the article titled "Microendoscopic lumbar discectomy: Technique and results of 188 cases." from Kulkarni et al. [1] with interest. The visualization device used in this technique is not an endoscope, but an operating microscope, as it is stated clearly on the final line of the first paragraph in the description of the operative procedure under materials and methods.

Microendoscopic discectomy (MED) was introduced in 1997 and refers to a tubular retractor system (MED) to approach the spine combined with a rigid endoscope to enable visualization. [2],[3] Further development of the MED system was the Minimal Exposure Tubular Retractor (METRx) system and especially the METRx MD system (Sofamor Danek, Memphis, TN). This system enabled the use of the microscope as visualization device. [3] The two techniques clearly differ in the visualization apparatus and should, therefore, be regarded as different. Both techniques use a tubular retractor system for the approach, but the use of one or the other visualization device, namely endoscope versus microscope, attributes various advantages and limitations to each one. [3]

The term "MED" should be used only to describe the use of the endoscope in combination with the tubular retractor system as it was originally introduced. [2],[3] On the contrary, there is no consent to a term that describes the use of the microscope in combination with the tubular retractor system. Thereafter, a periphrasis is usually used to declare this, e.g. tubular microdiscectomy, microscopically assisted tubular discectomy, minimally invasive microdiscectomy, etc.

In our neurosurgical clinic, we have used the microscopic tubular technique in over 1000 cases of microdiscectomy, [4] decompressive laminotomy, transforaminal lumbar interbody fusion and cervical dorsal foraminotomy.

I have no doubt about the good intentions and animus of the authors but the use of the term "MED" in the title of the mentioned article [1] is incorrect. In this respect, the antithesis between title and admittedly qualitative content of this article may lead to confusion when used in research or for educative purposes. I believe that a consensus of nomenclature is mandatory in order to assure that scientific knowledge is conveyed accurately to the international scientific and medical society and also transcends to the next generations.

 
   References Top

1.
Kulkarni AG, Bassi A, Dhruv A. Microendoscopic lumbar discectomy: Technique and results of 188 cases. Indian J Orthop 2014;48:81-7.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
Foley KT, Smith MM. Microendoscopic discectomy. Tech Neurosurg 1997;3:301-7.  Back to cited text no. 2
    
3.
Perez-Cruet MJ, Foley KT, Isaacs RE, Rice-Wyllie L, Wellington R, Smith MM, et al. Microendoscopic lumbar discectomy: Technical note. Neurosurgery 2002;51:S129-36.  Back to cited text no. 3
    
4.
Kogias E, Vougioukas VI, Hubbe U, Halatsch ME. Minimally invasive approach for the treatment of lateral lumbar disc herniations. Technique and results. Minim Invasive Neurosurg 2007;50:160-2.  Back to cited text no. 4
    

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Correspondence Address:
Evangelos Kogias
Department of Neurosurgery, University Medical Center Freiburg
Germany
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5413.152551

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