Recurrent Lumbar Disc Herniation: Does Transforaminal Lumbar Interbody Fusion Lead to Better Clinical and Radiological Outcomes than Redo-Discectomy?
Study Design randomized, prospective, and level I clinical study. Purpose To compare the clinical outcomes and radiological findings of revision discectomy alone versus revision discectomy with fusion as surgical treatment for recurrent lumbar disc herniation (RDH). Overview of Literature RDH is a c...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Spine Society
2023-10-01
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| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-2022-0210.pdf |
| _version_ | 1797644489459761152 |
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| author | Mohamed Mosaad Ali Khozamy Ahmed Samir Barakat Ihab Emran Yasser Elmeligy Alaa Abulhamd |
| author_facet | Mohamed Mosaad Ali Khozamy Ahmed Samir Barakat Ihab Emran Yasser Elmeligy Alaa Abulhamd |
| author_sort | Mohamed Mosaad |
| collection | DOAJ |
| description | Study Design randomized, prospective, and level I clinical study. Purpose To compare the clinical outcomes and radiological findings of revision discectomy alone versus revision discectomy with fusion as surgical treatment for recurrent lumbar disc herniation (RDH). Overview of Literature RDH is a common complication following a primary discectomy. The optimal surgical procedure for RDH is still debated. Methods Sixty patients with RDH were randomly divided into two equal groups: the first group underwent revision discectomy alone and the second underwent revision discectomy with fusion. The primary outcomes evaluated were Visual Analog Scale (VAS) for low back and limb pains, Oswestry Disability Index (ODI), disc height indexes, foraminal height index, and disc height subsidence. Secondary outcomes included operative time, blood loss, postoperative hospital stay, and complications. Results Revision discectomy with fusion showed superior pain relief and improved functional outcomes, including better VAS scores for both back and leg pain and ODI at 24-month follow-up. Additionally, it restored the stability of the spine better with lower disc height subsidence without significant complications. However, these advantages came at the cost of increased blood loss and longer operative time and hospital stays. Conclusions Revision discectomy with fusion is recommended for RDH; however, the choice of the procedure should be made case-by-case basis, considering many factors related to the patient and surgical facilities. |
| first_indexed | 2024-03-11T14:31:12Z |
| format | Article |
| id | doaj.art-769d35630b394cd1b2c758589900c4dd |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-03-11T14:31:12Z |
| publishDate | 2023-10-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-769d35630b394cd1b2c758589900c4dd2023-10-31T08:19:30ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462023-10-0117586286910.31616/asj.2022.02101552Recurrent Lumbar Disc Herniation: Does Transforaminal Lumbar Interbody Fusion Lead to Better Clinical and Radiological Outcomes than Redo-Discectomy?Mohamed Mosaad0Ali Khozamy1Ahmed Samir Barakat2Ihab Emran3Yasser Elmeligy4Alaa Abulhamd5Department of Orthopaedics, Cairo University, Giza, EgyptDepartment of Orthopaedics, Cairo University, Giza, EgyptDepartment of Orthopaedics, Cairo University, Giza, EgyptDepartment of Orthopaedics, Cairo University, Giza, EgyptDepartment of Orthopaedics, Cairo University, Giza, EgyptDepartment of Orthopaedics, Cairo University, Giza, EgyptStudy Design randomized, prospective, and level I clinical study. Purpose To compare the clinical outcomes and radiological findings of revision discectomy alone versus revision discectomy with fusion as surgical treatment for recurrent lumbar disc herniation (RDH). Overview of Literature RDH is a common complication following a primary discectomy. The optimal surgical procedure for RDH is still debated. Methods Sixty patients with RDH were randomly divided into two equal groups: the first group underwent revision discectomy alone and the second underwent revision discectomy with fusion. The primary outcomes evaluated were Visual Analog Scale (VAS) for low back and limb pains, Oswestry Disability Index (ODI), disc height indexes, foraminal height index, and disc height subsidence. Secondary outcomes included operative time, blood loss, postoperative hospital stay, and complications. Results Revision discectomy with fusion showed superior pain relief and improved functional outcomes, including better VAS scores for both back and leg pain and ODI at 24-month follow-up. Additionally, it restored the stability of the spine better with lower disc height subsidence without significant complications. However, these advantages came at the cost of increased blood loss and longer operative time and hospital stays. Conclusions Revision discectomy with fusion is recommended for RDH; however, the choice of the procedure should be made case-by-case basis, considering many factors related to the patient and surgical facilities.http://www.asianspinejournal.org/upload/pdf/asj-2022-0210.pdfrecurrent disctransforaminal lumbar interbody fusiondiskectomyfusionrediscectomy |
| spellingShingle | Mohamed Mosaad Ali Khozamy Ahmed Samir Barakat Ihab Emran Yasser Elmeligy Alaa Abulhamd Recurrent Lumbar Disc Herniation: Does Transforaminal Lumbar Interbody Fusion Lead to Better Clinical and Radiological Outcomes than Redo-Discectomy? Asian Spine Journal recurrent disc transforaminal lumbar interbody fusion diskectomy fusion rediscectomy |
| title | Recurrent Lumbar Disc Herniation: Does Transforaminal Lumbar Interbody Fusion Lead to Better Clinical and Radiological Outcomes than Redo-Discectomy? |
| title_full | Recurrent Lumbar Disc Herniation: Does Transforaminal Lumbar Interbody Fusion Lead to Better Clinical and Radiological Outcomes than Redo-Discectomy? |
| title_fullStr | Recurrent Lumbar Disc Herniation: Does Transforaminal Lumbar Interbody Fusion Lead to Better Clinical and Radiological Outcomes than Redo-Discectomy? |
| title_full_unstemmed | Recurrent Lumbar Disc Herniation: Does Transforaminal Lumbar Interbody Fusion Lead to Better Clinical and Radiological Outcomes than Redo-Discectomy? |
| title_short | Recurrent Lumbar Disc Herniation: Does Transforaminal Lumbar Interbody Fusion Lead to Better Clinical and Radiological Outcomes than Redo-Discectomy? |
| title_sort | recurrent lumbar disc herniation does transforaminal lumbar interbody fusion lead to better clinical and radiological outcomes than redo discectomy |
| topic | recurrent disc transforaminal lumbar interbody fusion diskectomy fusion rediscectomy |
| url | http://www.asianspinejournal.org/upload/pdf/asj-2022-0210.pdf |
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