Skip to main content
main-content

29.10.2019 | Original Article Open Access

Revision after failed discectomy

Zeitschrift:
European Spine Journal
Autoren:
Christoph Mehren, Lorenz Wanke-Jellinek, Andreas Korge
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00586-019-06194-9) contains supplementary material, which is available to authorized users.

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Abstract

Purpose

Recurrent lumbar disc herniation is the most common complication after discectomy. Due to the altered anatomy with the presence of scar tissue, the surgical revision of already operated patients could be a surgical challenge.

Methods

We describe the microsurgical revision technique step by step with the evaluation of our own clinical results in comparison with primary lumbar disc surgeries. The clinical data are based on a clinical register with 2576 recorded primary surgeries (PD) and 592 cases of revisions (RD) with 12- and 24-month follow-up (FU). The intraoperative dura lesion rates of the surgeries between 2016 and 2018 were recorded retrospectively. Data from 894 primary disc surgeries and 117 revisions were evaluated.

Results

The ODI and the VAS for leg and back pain improved in both groups significantly with slightly inferior outcome of the revision group. The ODI improved from 46.3 (PD) and 45.9 (RD), respectively, to 12.6 (PD) and 22.9 (RD) at the 24-month FU. The VAS dropped down as well in both group [VAS back: 47.8 (PD) and 43.9 (RD) to 19.9 and 32.2 at the 24-month FU; VAS leg: 62.9 (PD) and 65.5 (RD) to 15.6 and 26.8 at the 24-month FU]. During the primary interventions, we observed 1.5% (11/894) and during revisions 7.7% (9/117) of dura lesions.

Conclusions

There is no clear guideline for the surgical treatment of recurrent disc herniations. In most cases, a pure re-discectomy is sufficient and can be performed safely and effectively with the help of a microscope.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.

Unsere Produktempfehlungen

e.Med Interdisziplinär

Kombi-Abonnement

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de. Zusätzlich können Sie eine Zeitschrift Ihrer Wahl in gedruckter Form beziehen – ohne Aufpreis.

e.Med Orthopädie & Unfallchirurgie

Kombi-Abonnement

Mit e.Med Orthopädie & Unfallchirurgie erhalten Sie Zugang zu CME-Fortbildungen der Fachgebiete, den Premium-Inhalten der dazugehörigen Fachzeitschriften, inklusive einer gedruckten Zeitschrift Ihrer Wahl.

Zusatzmaterial
Supplementary material 1 (PPTX 225 kb)
586_2019_6194_MOESM1_ESM.pptx
Literatur
Über diesen Artikel

Neu im Fachgebiet Orthopädie und Unfallchirurgie

21.11.2019 | ACR 2019 | Kongressbericht | Onlineartikel

Anifrolumab bei SLE nun doch mit signifikanten Ergebnissen

21.11.2019 | ACR 2019 | Kongressbericht | Onlineartikel

Handarthrose: Tops und Flops vom ACR-Kongress

21.11.2019 | ACR 2019 | Kongressbericht | Onlineartikel

JAK - selektive Inhibitoren bei RA mit Vorteilen?

21.11.2019 | ACR 2019 | Kongressbericht | Onlineartikel

Erste Daten zur Differentialtherapie der PsA

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Orthopädie und Unfallchirurgie und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise