Micro-endoscopic strategies and options for recurrent lumbar disc herniation / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the results of micro-endoscopic revision surgery for recurrent disc herniation, and compare the results of disc excision with and without interbody fusion.</p><p><b>METHODS</b>A total of 32 patients included who had undergone micro-endoscopic revision discectomy for recurrent disc herniation with or without interbody fusion has been surveyed to assess their clinical outcome. The 27 patients who had been followed were divided into two groups; the micro-endoscopic discectomy alone 14 cases, the micro-endoscopic discectomy with interbody fusion 13 cases. With an average follow-up of 25.5 months. Clinical symptoms were assessed based on the VAS scores and Nakai criteria. All medical and surgical records were examined and analyzed, including intraoperative blood loss, length of surgery, and postsurgery hospital stay et al.</p><p><b>RESULTS</b>The statistical difference in the postoperative back pain and leg pain score compared with preoperative score were significant (P < 0.05) or very significant (P < 0.01). Clinical outcomes were excellent or good in 92.8% of patients undergoing a micro-endoscopic discectomy alone, and in 85.5% of patients with interbody fusion. The statistical difference between the fusion and non-fusion groups was insignificant (P = 0.793). But the two groups intraoperative blood loss, length of surgery, length of hospitalization and expenses were significantly less in patients undergoing discectomy alone than in patients with interbody fusion.</p><p><b>CONCLUSIONS</b>Micro-endoscopic revision surgery for recurrent disc herniation is very effective and safety. Micro-endoscopic discectomy alone is first choice for managing recurrent disc herniation.</p>