Revisional Percutaneous Full Endoscopic Disc Surgery for Recurrent Herniation of Previous Open Lumbar Discectomy

Overview

Journal Asian Spine J

Date 2011 Mar 10

PMID 21386940

Citations 18

Authors

Kyung Hyun Shin

Ho-Guen Chang

Nam Kyou Rhee

Kwahn Sue Lim

Affiliations

Soon will be listed here.

Abstract

Study Design: A retrospective study.

Purpose: To determine the feasibility and effectiveness of revisional percutaneous full endoscopic discectomy for recurrent herniation after conventional open disc surgery. OVERVIEW OF THE LITERATURE: Repeated open discectomy with or without fusion has been the most common procedure for recurrent lumbar disc herniation. Percutaneous endoscopic lumbar discectomy for recurrent herniation has been thought of as an impossible procedure. Despite good results with open revisional surgery, major problems may be caused by injuries to the posterior stabilized structures. Our team did revisional full endoscopic lumbar disc surgery on the basis of our experience doing primary full endoscopic disc surgery.

Methods: Between February 2004 and August 2009 a total of 41 patients in our hospital underwent revisional percutaneous endoscopic lumbar discectomy using a YESS endoscopic system and a micro-osteotome (designed by the authors). Indications for surgery were recurrent disc herniation following conventional open discectomy; with compression of the nerve root revealed by Gadolinium-enhanced magnetic resonance imaging; corresponding radiating pain which was not alleviated after conservative management over 6 weeks. Patients with severe neurologic deficits and isolated back pain were excluded.

Results: The mean follow-up period was 16 months (range, 13 to 42 months). The visual analog scale for pain in the leg and back showed significant post-treatment improvement (p < 0.001). Based on a modified version of MacNab's criteria, 90.2% showed excellent or good outcomes. There was no measurable blood loss. There were two cases of recurrence of and four cases with complications.

Conclusions: Percutaneous full-endoscopic revisional disc surgery without additional structural damage is feasible and effective in terms of there being less chance of fusion and bleeding. This technique can be an alternative to conventional repeated discectomy.

Citing Articles

Functional Outcomes After Discectomy for Recurrent Lumbar Herniation Using the Destandau Endospine System: A Retrospective Study of 44 Patients.

Dey P, Nanda S, Samant S, Gachhayat A Cureus. 2024; 15(11):e49753.

PMID: 38161918 PMC: 10757674. DOI: 10.7759/cureus.49753.

Clinical Effects of the End-Love Technique in the Treatment of Recurrent Lumbar Disc Herniation 1 Year After Surgery.

Li P, Li X, Ma L, He H Orthop Res Rev. 2023; 15:225-236.

PMID: 38028654 PMC: 10659146. DOI: 10.2147/ORR.S433846.

Surgical Strategy and Outcomes of Full Endoscopic Lumbar Discectomy for Recurrent Lumbar Disk Herniation Following a Previous Full Endoscopic Lumbar Discectomy.

Wang Y, Liu H, Lin A, Zhang H, Ma X Orthop Surg. 2023; 15(10):2602-2611.

PMID: 37537498 PMC: 10549842. DOI: 10.1111/os.13844.

Percutaneous Endoscopic Lumbar Discectomy for Recurrent Lumbar Disc Herniation: An Updated Systematic Review and Meta-Analysis.

Lu H, Yao Y, Shi L Indian J Orthop. 2022; 56(6):983-995.

PMID: 35669028 PMC: 9123128. DOI: 10.1007/s43465-022-00636-1.

Comparison of Primary Versus Revision Lumbar Discectomy Using a Biportal Endoscopic Technique.

Kang M, Park H, You K, Choi D, Park C, Chung H Global Spine J. 2022; 13(7):1918-1925.

PMID: 35176889 PMC: 10556890. DOI: 10.1177/21925682211068088.

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