New Approaches to Surgical Treatment of Recurrent Lumbar Intervertebral Disc Herniation

Objective. To assess feasibility of the proposed anterior decompression and stabilization surgery without meningoradicu- lolysis for recurrent herniation of the lumbar intervertebral disc. Material and Methods. Prospective randomized controlled study involved comparative evaluation of two essentia...

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Main Authors: Anatoly A. Lutsik, Igor V. Gavrilov, Gleb Yu. Bondarenko, Aleksandr G. Epifantsev, Anatoly I. Peganov
Format: Article
Language:English
Published: Ministry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan" 2015-03-01
Series:Хирургия позвоночника
Subjects:
Online Access:https://www.spinesurgery.ru/jour/article/view/392/1393
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author Anatoly A. Lutsik
Igor V. Gavrilov
Gleb Yu. Bondarenko
Aleksandr G. Epifantsev
Anatoly I. Peganov
author_facet Anatoly A. Lutsik
Igor V. Gavrilov
Gleb Yu. Bondarenko
Aleksandr G. Epifantsev
Anatoly I. Peganov
author_sort Anatoly A. Lutsik
collection DOAJ
description Objective. To assess feasibility of the proposed anterior decompression and stabilization surgery without meningoradicu- lolysis for recurrent herniation of the lumbar intervertebral disc. Material and Methods. Prospective randomized controlled study involved comparative evaluation of two essentially different surgical interventions performed in 130 patients with recurrent disc herniation in 2005–2012. The control group included 62 patients who underwent posterior decompression and stabilization surgery with meningoradiculolysis to re- move the herniated disc. The study group included 68 patients who underwent the proposed anterior decompression and stabilization surgery, which differs by an obligate opening of the spinal canal and intervertebral foramen to remove the disc herniation through an anterior approach without meningoradiculolysis. Results. Immediate results of anterior and posterior decompression and stabilization operations are comparable, though posterior interventions are more frequently associated with iatrogenic injury to posterior nerve roots caused by intervertebral implant insertion and meningoradiculolysis required before the disc herniation removal. Long-term outcomes of anterior operations are reliably better. Conclusion. Anterior decompression and stabilization operations for recurrent disc herniation compare favorably to posterior ones, since they are less traumatizing to the nerve roots and prevent herniation recurrence and epidural fibrosis progression.
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spelling doaj.art-1625ceb4686b4721aa92610b16c03c962023-09-02T22:32:42ZengMinistry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan"Хирургия позвоночника1810-89972313-14972015-03-0112161310.14531/ss2015.1.36-45New Approaches to Surgical Treatment of Recurrent Lumbar Intervertebral Disc HerniationAnatoly A. Lutsik0Igor V. Gavrilov1Gleb Yu. Bondarenko2Aleksandr G. Epifantsev3Anatoly I. Peganov4Novokuznetsk State Institute of Postgraduate Medicine, Novokuznetsk, Russia; Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan, Novosibirsk, RussiaNovokuznetsk State Institute of Postgraduate Medicine, Novokuznetsk, RussiaNovokuznetsk State Institute of Postgraduate Medicine, Novokuznetsk, RussiaNovokuznetsk State Institute of Postgraduate Medicine, Novokuznetsk, RussiaNovokuznetsk State Institute of Postgraduate Medicine, Novokuznetsk, RussiaObjective. To assess feasibility of the proposed anterior decompression and stabilization surgery without meningoradicu- lolysis for recurrent herniation of the lumbar intervertebral disc. Material and Methods. Prospective randomized controlled study involved comparative evaluation of two essentially different surgical interventions performed in 130 patients with recurrent disc herniation in 2005–2012. The control group included 62 patients who underwent posterior decompression and stabilization surgery with meningoradiculolysis to re- move the herniated disc. The study group included 68 patients who underwent the proposed anterior decompression and stabilization surgery, which differs by an obligate opening of the spinal canal and intervertebral foramen to remove the disc herniation through an anterior approach without meningoradiculolysis. Results. Immediate results of anterior and posterior decompression and stabilization operations are comparable, though posterior interventions are more frequently associated with iatrogenic injury to posterior nerve roots caused by intervertebral implant insertion and meningoradiculolysis required before the disc herniation removal. Long-term outcomes of anterior operations are reliably better. Conclusion. Anterior decompression and stabilization operations for recurrent disc herniation compare favorably to posterior ones, since they are less traumatizing to the nerve roots and prevent herniation recurrence and epidural fibrosis progression.https://www.spinesurgery.ru/jour/article/view/392/1393surgical treatmentrecurrence of disc herniation
spellingShingle Anatoly A. Lutsik
Igor V. Gavrilov
Gleb Yu. Bondarenko
Aleksandr G. Epifantsev
Anatoly I. Peganov
New Approaches to Surgical Treatment of Recurrent Lumbar Intervertebral Disc Herniation
Хирургия позвоночника
surgical treatment
recurrence of disc herniation
title New Approaches to Surgical Treatment of Recurrent Lumbar Intervertebral Disc Herniation
title_full New Approaches to Surgical Treatment of Recurrent Lumbar Intervertebral Disc Herniation
title_fullStr New Approaches to Surgical Treatment of Recurrent Lumbar Intervertebral Disc Herniation
title_full_unstemmed New Approaches to Surgical Treatment of Recurrent Lumbar Intervertebral Disc Herniation
title_short New Approaches to Surgical Treatment of Recurrent Lumbar Intervertebral Disc Herniation
title_sort new approaches to surgical treatment of recurrent lumbar intervertebral disc herniation
topic surgical treatment
recurrence of disc herniation
url https://www.spinesurgery.ru/jour/article/view/392/1393
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