Clinical outcomes after minimal-access surgery for recurrent lumbar disc herniation

Le, Hoang; Sandhu, Faheem A.; Fessler, Richard G.

doi:10.3171/foc.2003.15.3.12

Cited by 61 publications

(41 citation statements)

References 17 publications

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“…33 The overall success rate of 90% in our series is comparable to reported success rates of MED and ETD in the literature. 1,7,14,15,24,25,32,39,43 The mean operative time of 90 ± 35 minutes is comparable to other series using MED (98-102 minutes). 15,24,25 The instability/fusion rate in our series was 6.7%.…”

Section: Discussionsupporting

confidence: 67%

“…1,7,14,15,24,25,32,39,43 The mean operative time of 90 ± 35 minutes is comparable to other series using MED (98-102 minutes). 15,24,25 The instability/fusion rate in our series was 6.7%. In another series of 16 patients 43 and in two 10-patient series described by Le et al 24 and Isaacs et al 15 in 2003, no case of instability and fusion was reported.…”

Section: Discussionsupporting

confidence: 67%

“…15,24,25 The instability/fusion rate in our series was 6.7%. In another series of 16 patients 43 and in two 10-patient series described by Le et al 24 and Isaacs et al 15 in 2003, no case of instability and fusion was reported. In our series, we report an incidental durotomy rate of 16.7%.…”

Section: Discussionmentioning

confidence: 78%

“…6,18,43,48 Our reported incidence is clearly higher than in the ETD (nil) 1,14,39 and slightly higher than in MED (7.4%-12.5%). 15,24,32,43 Compared with a series of patients that were treated with open revision microdiscectomy in our clinic (data not shown), the durotomy incidence rate is not significantly higher. Thus, we do not regard working through the minimally invasive access tube and the use of longer instruments as limiting factors that may increase the durotomy incidence rate.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4][11][12][13][20][21][22]26,49 Also, full endoscopic techniques have been used for the treatment of LDH via an interlaminar or transforaminal (endoscopic transforaminal discectomy [ETD]) approach. 16,[28][29][30][36][37][38][39][40][41]53 Over the last decade, MED and ETD have been applied to treat recurrent LDH 1,7,14,15,24,25,32,39,43 (Table 1). The outcomes were reported to be equal and sometimes favorable compared with open microdiscectomy for recurrent LDH.…”

mentioning

confidence: 99%

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Minimally invasive tubular microdiscectomy for recurrent lumbar disc herniation

Hubbe¹,

Franco-Jimenez²,

Klingler³

et al. 2016

SPI

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OBJECT The aim of the study was to investigate the safety and efficacy of minimally invasive tubular microdiscectomy for the treatment of recurrent lumbar disc herniation (LDH). As opposed to endoscopic techniques, namely microendoscopic and endoscopic transforaminal discectomy, this microscopically assisted technique has never been used for the treatment of recurrent LDH. METHODS Thirty consecutive patients who underwent minimally invasive tubular microdiscectomy for recurrent LDH were included in the study. The preoperative and postoperative visual analog scale (VAS) scores for pain, the clinical outcome according to modified Macnab criteria, and complications were analyzed retrospectively. The minimum follow-up was 1.5 years. Student t-test with paired samples was used for the statistical comparison of pre- and postoperative VAS scores. A p value < 0.05 was considered to be statistically significant. RESULTS The mean operating time was 90 ± 35 minutes. The VAS score for leg pain was significantly reduced from 5.9 ± 2.1 preoperatively to 1.7 ± 1.3 postoperatively (p < 0.001). The overall success rate (excellent or good outcome according to Macnab criteria) was 90%. Incidental durotomy occurred in 5 patients (16.7%) without neurological consequences, CSF fistula, or negative influence to the clinical outcome. Instability occurred in 2 patients (6.7%). CONCLUSIONS The clinical outcome of minimally invasive tubular microdiscectomy is comparable to the reported success rates of other minimally invasive techniques. The dural tear rate is not associated to higher morbidity or worse outcome. The technique is an equally effective and safe treatment option for recurrent LDH.