Extensive Laminectomy for Redo Lumbar Discectomy; Could it Be A Successful Alternative Option in Stable Single Level Post Inter-Laminar First Recurrence?
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- Category: Vol. 84, December 2016
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Extensive Laminectomy for Redo Lumbar Discectomy; Could it Be A Successful Alternative Option in Stable Single Level Post Inter-Laminar First Recurrence?, MOHAMED LOTFY, SAMEH A. SAKR and ASHRAF E. ZAGHLOUL
Abstract
Background: Recurrence after lumbar discectomy cannot be prevented. Recurrence rates vary between 5 to 20% being independent from the technique employed. If the patients can no longer tolerate the pain, there are different surgical options on how to handle the disc re-herniation.
Objective: To assess extensive laminectomy as a possible option for redo discectomy in stable single level post inter-laminar first recurrence in well selected patients with sciatica as main complaint.
Patients and Methods: A prospective study of redo dis-cectomy through extensive laminectomy with one year follow-up in selected 28 patients aged 23 to 58 years, with recurrent single level stable lumbar disc herniation that previously underwent inter-laminar discectomy, revision done at L 4-5 level in 19 cases (67, 85%) and at L5-S1 level in 9 cases (32. 1 %). All suffer from sciatica as the main complaint, which was proven radiologically to be attributed to recurrent stable single level lumbar disc herniation.
Results: The mean of preoperative Visual Analogue Score (VAS) for leg pain was 81.25 and improved to 24.7 at 12 months postoperatively. One year postoperative the rate of improvement according to the JOA score system for low-back pain ranged between 55.5%-91.6% (Mean±SD=75.4%±9.2). 25 patients (89.3%) have no interruption of work or daily life activities according to post-operative Dennis pain scale.
Conclusion: This technique seems to be a successful alternative surgical option for redo.
Discectomy in stable single level post inter-laminar first recurrence in well selected patients with sciatica as the main complaint with no or mild low back pain.