Re-Operation after Lumbar Disc Surgery: Results in 85 Cases

In this retrospective study, 85 patients previously operated on for lumbar disc herniation who had undergone reoperation due to persistent pain or recurrence of the symptoms were investigated. The surgical findings were: recurrent herniation (20%), epidural fibrosis alone (36.4%), small recurrent herniation with epidural fibrosis (28.2%), herniation at another level (10.6%), spinal stenosis (2.4%), lumbar pseudomeningocele (1.2%) and adhesive arachnoiditis (1.2%). The overall success rate of re-operation was 60%. The best results were obtained in recurrent disc herniation (47.1% excellent and 35.3% good results) and in herniation at another level (77.8% excellent and 22.2% good). Re-operation in epidural fibrosis had less-satisfactory results (29.1% excellent and 12.9% good).

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Complications of Lumbar Disc Herniation Following Full-endoscopic Interlaminar Lumbar Discectomy: A Large, Single-Center, Retrospective Study

January 2018 - Pain Physician ◽

10.36076/ppj.2017.e287 ◽

2017 ◽

Vol 3 (20;3) ◽

pp. E379-E387

Author(s):

Jian-Cheng Zeng

Keyword(s):

Retrospective Study ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Complication Rate ◽

Lumbar Disc ◽

Lumbar Discectomy ◽

Single Center ◽

Nerve Root Injury ◽

Root Injury ◽

Recurrent Herniation

Background: The new surgical procedure of full-endoscopic interlaminar lumbar discectomy (FILD) has achieved favorable effects in the treatment of lumbar disc herniation (LDH). Along with the wide range of applications of FILD, a series of complications related to the operation has gradually emerged. Objective: To describe the types, incidences, and characteristics of complications following FILD and to explore preventative and treatment measures. Study Design: Retrospective, observational study. Setting: A spine center affiliated with a large general hospital. Method: In total, 479 patients with LDH underwent FILDs that were performed by a single experienced spine surgeon between January 2010 and April 2013.Data concerning the complications were recorded. Results: All 479 cases successfully underwent the procedure. A total of 482 procedures were completed. The mean follow-up time was 44.3 months with a range of 24 to 60 months. The average patient age was 47.8 years with a range of 16 to 76 years. Twenty-nine (6.0%) related complications emerged, including 3 cases (0.6%) of incomplete decompression in which the symptoms gradually decreased following 3 – 6 weeks of conservative treatment, 2 cases (0.4%) of nerve root injury in which the patients recovered well following 1 – 3 months of neurotrophic drug and functional exercise treatment, 15 cases (3.1%) of paresthesia that gradually improved following 1 – 8 weeks of rehabilitation exercises and treatment with mecobalamin and pregabalin, and 9 cases of recurrent herniation (1.9%). The latter condition was controlled in 4 cases with a conservative method, and 5 of these cases underwent reoperations that included 3 traditional open surgeries and 2 FILDs. Furthermore, the complication rate for the first 100 cases was 18%. This rate decreased to 2.9% for cases 101 – 479. The incidence of L4-5 herniation (8.2%) was significantly greater than that of L5-S1 (4.5%). Limitations: This is a retrospective study, and some bias exists due to the single-center study design. Conclusion: FILD is a surgical approach that has a low complication rate. Incomplete decompression, nerve root injury, paresthesia, and recurrent herniation were observed in our study. Some effective measures can prevent and reduce the incidence of the complications including strict indications for surgery, a thorough action plan, and a high level of surgical skill. Key words: Complication, lumbar disc herniation, lumbar discectomy, endoscopic, inter-laminar discectomy, minimally invasive spine surgery

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Outcomes of Microendoscopic Discectomy and Percutaneous Transforaminal Endoscopic Discectomy for the Treatment of Lumbar Disc Herniation: A Comparative Retrospective Study

Asian Spine Journal ◽

10.4184/asj.2015.9.6.833 ◽

2015 ◽

Vol 9 (6) ◽

pp. 833 ◽

Cited By ~ 29

Author(s):

Arjun Sinkemani ◽

Xin Hong ◽

Zeng-Xin Gao ◽

Su-Yang Zhuang ◽

Zan-Li Jiang ◽

...

Keyword(s):

Retrospective Study ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Endoscopic Discectomy ◽

Percutaneous Transforaminal Endoscopic Discectomy ◽

Microendoscopic Discectomy

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Surgical treatment of the lumbar disc herniation complicated by lumbar spinal stenosis

Ukrainian Neurosurgical Journal ◽

10.25305/unj.182625 ◽

2020 ◽

Vol 26 (1) ◽

pp. 5-12 ◽

Cited By ~ 1

Author(s):

Mykhaylo V. Khyzhnyak ◽

Artur Yu. Ksenzov ◽

Tymur A. Ksenzov

Keyword(s):

Surgical Treatment ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Lumbar Spinal

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Relationship Between Rates and Outcomes of Operative Treatment for Lumbar Disc Herniation and Spinal Stenosis

The Journal of Bone and Joint Surgery (American) ◽

10.2106/00004623-199906000-00002 ◽

1999 ◽

Vol 81 (6) ◽

pp. 752-62 ◽

Cited By ~ 73

Author(s):

ROBERT B. KELLER ◽

STEVEN J. ATLAS ◽

DAVID N. SOULE ◽

DANIEL E. SINGER ◽

RICHARD A. DEYO

Keyword(s):

Spinal Stenosis ◽

Operative Treatment ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc

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Hybrid Interlaminar Endoscopic Lumbar Decompression in Disc Herniation Combined With Spinal Stenosis

Operative Neurosurgery ◽

10.1093/ons/opaa360 ◽

2020 ◽

Author(s):

Kuo-Tai Chen ◽

Kyung-Chul Choi ◽

Myung-Soo Song ◽

Hussam Jabri ◽

Yadhu K Lokanath ◽

...

Keyword(s):

Spinal Stenosis ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Lumbar Discectomy ◽

Leg Pain ◽

Lumbar Decompression ◽

Lateral Recess Stenosis ◽

Endoscopic Discectomy ◽

The Mean

Abstract BACKGROUND Endoscopic spine surgery is an alternative to the traditional treatment of lumbar disc herniation. However, the traditional technique of interlaminar endoscopic approach is challenging and risky in patients with concomitant spinal stenosis. OBJECTIVE To report a modified technique called hybrid interlaminar endoscopic lumbar decompression as an effective treatment. METHODS Patients with combined lumbar disc herniation and lateral recess stenosis undergoing full-endoscopic interlaminar lumbar discectomy were retrospectively studied. The hybrid interlaminar endoscopic discectomy technique, as well as the use of 2 endoscopes with different diameters, is described in detail. The large endoscope is used for the laminotomy procedure, while the small endoscope is used for the discectomy procedure. The demographics and clinical outcomes of the patients are presented. RESULTS A total of 19 patients were included in this study. The mean age was 46.7 yr. The visual analog scale for back and leg pain improved from 5.6 ± 3.4 and 7.5 ± 2.3 to 1.8 ± 1.3 and 1.8 ± 1.6, respectively (P < .001). The mean Oswestry Disability Index improved from 59.9 ± 21.2 preoperatively to 18.2 ± 8.5 postoperatively (P < .001). The follow-up was 8.2 mo on average. No major complications occurred, but 2 patients reported mild postoperative paresthesia. One patient had an early recurrence and underwent repeat endoscopic discectomy. CONCLUSION Full-endoscopic lumbar discectomy provides excellent access to the intracanalicular herniation site of an intervertebral disc. By using the endoscopic technique presented here, surgeons can safely and efficiently achieve adequate decompression in patients with lumbar disc herniation combined with spinal stenosis.

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Preoperative retrolisthesis as a risk factor of postdecompression lumbar disc herniation

Journal of Neurosurgery Spine ◽

10.3171/2015.6.spine15288 ◽

2016 ◽

Vol 24 (4) ◽

pp. 592-601 ◽

Cited By ~ 4

Author(s):

Shota Takenaka ◽

Kosuke Tateishi ◽

Noboru Hosono ◽

Yoshihiro Mukai ◽

Takeshi Fuji

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Area Under The Curve ◽

Lumbar Spinal ◽

Acute Sciatica

OBJECT In this study, the authors aimed to identify specific risk factors for postdecompression lumbar disc herniation (PDLDH) in patients who have not undergone discectomy and/or fusion. METHODS Between 2007 and 2012, 493 patients with lumbar spinal stenosis underwent bilateral partial laminectomy without discectomy and/or fusion in a single hospital. Eighteen patients (herniation group [H group]: 15 men, 3 women; mean age 65.1 years) developed acute sciatica as a result of PDLDH within 2 years after surgery. Ninety patients who did not develop postoperative acute sciatica were selected as a control group (C group: 75 men, 15 women; mean age 65.4 years). Patients in the C group were age and sex matched with those in the H group. The patients in the groups were also matched for decompression level, number of decompression levels, and surgery date. The radiographic variables measured included percentage of slippage, intervertebral angle, range of motion, lumbar lordosis, disc height, facet angle, extent of facet removal, facet degeneration, disc degeneration, and vertebral endplate degeneration. The threshold for PDLDH risk factors was evaluated using a continuous numerical variable and receiver operating characteristic curve analysis. The area under the curve was used to determine the diagnostic performance, and values greater than 0.75 were considered to represent good performance. RESULTS Multivariate analysis revealed that preoperative retrolisthesis during extension was the sole significant independent risk factor for PDLDH. The area under the curve for preoperative retrolisthesis during extension was 0.849; the cutoff value was estimated to be a retrolisthesis of 7.2% during extension. CONCLUSIONS The authors observed that bilateral partial laminectomy, performed along with the removal of the posterior support ligament, may not be suitable for lumbar spinal stenosis patients with preoperative retrolisthesis greater than 7.2% during extension.

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