• Jaskaran Singh Gosal, Jigish Ruparelia, Mayank Garg, Suryanarayanan Bhaskar, Surjit Singh, and Deepak Kumar Jha.
• Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India.
• World Neurosurg. 2021 Aug 1; 152: 44-55.

ObjectiveTo do a comparative surgical outcome and cost-benefit analysis of our simple modified Taylor retractor with both open and tubular techniques in lumbar discectomy.MethodsWe retrospectively divided 52 lumbar disc patients operated by 2 different techniques between January 2019 and June 2020 into 2 groups- group 1 (n = 20): standard open macrodiscectomy (4-5 cm incision); group 2 (n = 32): unilateral translaminar microdiscectomy using our modified Taylor retractor with a small incision (18-20 mm, comparable to the tubular retractor). We compared both groups in terms of surgical outcomes and cost-benefit analysis. In addition, a cost-benefit comparison between our modified Taylor technique and that of the already published tubular microdiscectomy cohort was done.ResultsComplete symptom resolution occurred in 85% group 1 and 84.4% group 2 patients, with no difference in complication rates. Mean hospital stay was significantly less in group 2 (1.2 ± 0.37 days) as compared with group 1 (2.4 ± 1.15, P < 0.001). The mean total cost per patient was $2253.17 ± 69.16 in the modified Taylor microdiscectomy group compared with $2495.76 ± 214.85 (P < 0.001) in standard macrodiscectomy. Compared with the previously published tubular microdiscectomy cohort ($3069.91 ± 69.16), the modified Taylor retractor was $816.74 cheaper per patient with similar length of incision, surgical outcome, and hospital stay.ConclusionsSimilar clinical outcomes at decreased costs are obtained using the modified Taylor retractor compared with the tubular retractor. The modified Taylor retractor has a simple design, is user-friendly, and frugal alternative to the tubular retractor system for microscopic discectomy, especially in the resource-constrained countries.Copyright © 2021 Elsevier Inc. All rights reserved.

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