Original Article

Endoscopic Transforaminal Discectomy For Recurrent Lumbar Disc Herniation

M Schubert, T Hoogland, A Helmbrecht, C Schultz, C Wagner

Citation

M Schubert, T Hoogland, A Helmbrecht, C Schultz, C Wagner. Endoscopic Transforaminal Discectomy For Recurrent Lumbar Disc Herniation. The Internet Journal of Minimally Invasive Spinal Technology. 2010 Volume 4 Number 1.

Abstract

Background Recurrent herniation is a significant problem as scar formation and progressive disc degeneration may lead to increased morbidity after traditional posterior re-operation. PurposeTo review complications and results of the endoscopic transforaminal discectomy (ETD) for recurrent herniated discs. Study DesignA prospective clinical study.Patient Sample262 consecutive patients over a four year period with a MRI proven disc-herniation in the lumbar spine with radicular symptoms, positive Lasegue, numbness or adynamia in the leg that did not respond satisfactory to conservative treatment over 3 months. Previous surgery had been performed in our own centre in 82 cases, 180 patients had previous surgery performed elsewhere. Outcome MeasuresThe patients had a clinical evaluation 3 months after surgery and returned at two years an extensive questionnaire.MethodsThe prolapsed or ruptured part of the posterior disc segment was removed with special forceps and special curettesResultsAt two years 85,7% of the patients rated the result of the surgery as excellent or good. 9,7 % reported a fair and 4,6 % patients an unsatisfactory result. All patients had a 3-month follow-up where possible complications were registered. The complication included: 3 nerve root irritations and 6 (2,3%) early recurrent herniations (<3 month). There was no case of infection or discitis. 11 patients have been re-operated for recurrence, after 3 months and within 2 years ( 4,6%).ConclusionEndoscopic transforaminal discectomy appears to be an effective treatment with few complications and a high patient satisfaction for recurrent disc herniation.

 

References

Author Information

Michael Schubert
Spine Department, Apex Spine Center Munich, Germany

Thomas Hoogland
Spine Department, Apex Spine Center Munich, Germany

Armin Helmbrecht
Spine Department, Apex Spine Center Munich, Germany

Christian Schultz
Spine Department, Apex Spine Center Munich, Germany

Christian Wagner
Spine Department, Apex Spine Center Munich, Germany

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