Recurrent Lumbar Disc Herniation: Conventional Re-discectomy Versus TLIF with Unilateral Fixation

Background Data: Recurrent lumbar disc herniation is reported from 5 to 11%. Optimal surgical approach for recurrent disc prolapse is controversial. Some authors believe that repeat discectomy is the treatment of choice, with similar clinical results compared to the primary procedure. Some spine sur...

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Autores principales:	Tariq Awad, Salem Faisel
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2016
Materias:	Recurrent Lumbar disc herniation Discectomy Unilateral pedicle screws Transforaminal lumbar interbody fusion Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/98d7b9f5b92f423f833b4cb8317d0b70
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spelling	oai:doaj.org-article:98d7b9f5b92f423f833b4cb8317d0b702021-12-02T03:39:44ZRecurrent Lumbar Disc Herniation: Conventional Re-discectomy Versus TLIF with Unilateral FixationDOI:10.21608/ESJ.2016.40932314-89502314-8969https://doaj.org/article/98d7b9f5b92f423f833b4cb8317d0b702016-10-01T00:00:00Zhttp://www.esj.journals.ekb.eg/article_4093.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: Recurrent lumbar disc herniation is reported from 5 to 11%. Optimal surgical approach for recurrent disc prolapse is controversial. Some authors believe that repeat discectomy is the treatment of choice, with similar clinical results compared to the primary procedure. Some spine surgeons believe that fusion is necessary for treating disc reherniation. Purpose: Our aim is to compare the clinical outcome in patients with recurrent lumbar disc herniation operated by conventional rediscetomy versus those operated by TLIF with unilateral pedicle screw fixation. Study Design: A descriptive controlled, non-randomized, retrospective, clinical study. Patients and Methods: Forty patients underwent surgery for recurrent lumbar disc herniation. They were divided into two groups; re-discectomy group and TLIF with unilateral fixation group. Each group included 20 patients. They were operated between 2008 and 2016. Participants were evaluated pre-operatively and post-operatively every three months. Operative time, hospital stay and complications were assessed. Pain was scored by a VAS for both lower limbs and back pain. The clinical outcomes were compared using the Prolo economic and functional rating scale. In addition fusion was looked for radiologically. Results: The two groups of patients were fairly homogeneous and comparable. TLIF group showed better clinical outcome parameters including better VAS for low back pain and better Prolo economic, functional rating scale. In comparison the re-discectomy group showed significantly higher complications and reoperation during the follow up period. Conclusion: Patients with recurrent lumbar disc herniation operated by TLIF with unilateral spinal fixation reported less pain & lower disability scores all over the follow up period. This technique is preferable to conventional re-discectomy because it avoids the possibility of recurrence and has less postoperative complications. (2016ESJ124)Tariq AwadSalem FaiselEgyptian Spine AssociationarticleRecurrent Lumbar disc herniationDiscectomyUnilateral pedicle screwsTransforaminallumbar interbody fusionNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 20, Iss 1, Pp 18-27 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Recurrent Lumbar disc herniation Discectomy Unilateral pedicle screws Transforaminal lumbar interbody fusion Neurology. Diseases of the nervous system RC346-429
spellingShingle	Recurrent Lumbar disc herniation Discectomy Unilateral pedicle screws Transforaminal lumbar interbody fusion Neurology. Diseases of the nervous system RC346-429 Tariq Awad Salem Faisel Recurrent Lumbar Disc Herniation: Conventional Re-discectomy Versus TLIF with Unilateral Fixation
description	Background Data: Recurrent lumbar disc herniation is reported from 5 to 11%. Optimal surgical approach for recurrent disc prolapse is controversial. Some authors believe that repeat discectomy is the treatment of choice, with similar clinical results compared to the primary procedure. Some spine surgeons believe that fusion is necessary for treating disc reherniation. Purpose: Our aim is to compare the clinical outcome in patients with recurrent lumbar disc herniation operated by conventional rediscetomy versus those operated by TLIF with unilateral pedicle screw fixation. Study Design: A descriptive controlled, non-randomized, retrospective, clinical study. Patients and Methods: Forty patients underwent surgery for recurrent lumbar disc herniation. They were divided into two groups; re-discectomy group and TLIF with unilateral fixation group. Each group included 20 patients. They were operated between 2008 and 2016. Participants were evaluated pre-operatively and post-operatively every three months. Operative time, hospital stay and complications were assessed. Pain was scored by a VAS for both lower limbs and back pain. The clinical outcomes were compared using the Prolo economic and functional rating scale. In addition fusion was looked for radiologically. Results: The two groups of patients were fairly homogeneous and comparable. TLIF group showed better clinical outcome parameters including better VAS for low back pain and better Prolo economic, functional rating scale. In comparison the re-discectomy group showed significantly higher complications and reoperation during the follow up period. Conclusion: Patients with recurrent lumbar disc herniation operated by TLIF with unilateral spinal fixation reported less pain & lower disability scores all over the follow up period. This technique is preferable to conventional re-discectomy because it avoids the possibility of recurrence and has less postoperative complications. (2016ESJ124)
format	article
author	Tariq Awad Salem Faisel
author_facet	Tariq Awad Salem Faisel
author_sort	Tariq Awad
title	Recurrent Lumbar Disc Herniation: Conventional Re-discectomy Versus TLIF with Unilateral Fixation
title_short	Recurrent Lumbar Disc Herniation: Conventional Re-discectomy Versus TLIF with Unilateral Fixation
title_full	Recurrent Lumbar Disc Herniation: Conventional Re-discectomy Versus TLIF with Unilateral Fixation
title_fullStr	Recurrent Lumbar Disc Herniation: Conventional Re-discectomy Versus TLIF with Unilateral Fixation
title_full_unstemmed	Recurrent Lumbar Disc Herniation: Conventional Re-discectomy Versus TLIF with Unilateral Fixation
title_sort	recurrent lumbar disc herniation: conventional re-discectomy versus tlif with unilateral fixation
publisher	Egyptian Spine Association
publishDate	2016
url	https://doaj.org/article/98d7b9f5b92f423f833b4cb8317d0b70
work_keys_str_mv	AT tariqawad recurrentlumbardischerniationconventionalrediscectomyversustlifwithunilateralfixation AT salemfaisel recurrentlumbardischerniationconventionalrediscectomyversustlifwithunilateralfixation
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Recurrent Lumbar Disc Herniation: Conventional Re-discectomy Versus TLIF with Unilateral Fixation

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