Reperforming Minimally Invasive Microdiscectomy Approaches for Recurrent Lumbar Intervertebral Disc Prolapse

Abstract

Background Data: Reperforming minimally invasive discectomy (MID) approaches are typically challenging and demanding for patients with recurrent lumbar disc herniation (rLDH). Purpose: The aim of this study to assess the safety and efficacy of reperforming Minimally invasive discectomy in recurrent lumbar disc herniation surgery. Study Design: Retrospective clinical case study. Patients and Methods:The author reviewed the medical records all patients reoperated after MID during the period from June 2010 to April 2016 via minimally invasive approaches for recurrent lumbar disc herniation. Age, gender, presenting symptoms, disc herniation level and side, type of MID approach used in first surgery, period between 1 st and 2 nd surgeries, redo surgery duration, intra or post-operative complications, visual analogue scale VAS for pain at 1, 30, and 90 days postoperatively were recorded. Results: We could track 18 patients (12 males, 6 females), with mean age 43.2±6.3 years. The most operated level was L4/5 in 12 patients. Disc herniation on the left side was presented in 11 patients. Mean duration between the two surgeries was 44±19 weeks. Main clinical presentations were recurrent leg pain in 16 patients and new onset of partial foot drop in 2 patients. Duration of redo surgery was 97±37 minutes. Intraoperative minor dural tears were reported in 2 with no serious sequels. VAS for leg pain improved from 7.3±1.2 preoperatively to 2.1±1.1, 1.4±0.5 and 1.2±0.4 at 1, 30 and 90 postoperative days respectively. Conclusion: MID approach for rLDH following initial MID surgery sounds feasible option with better perioperative and short-term outcome. Clinical outcome in the present study showed favourable outcome regarding operative time and incidence of dural tears with CSF leak comparing to open approaches. (2017ESJ151)