Day Case Lumbar Fusion Surgery
The article compares the clinical outcome of minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) with standard revision discectomy for recurrent lumbar disc herniation (RLDH). The study involved 90 patients who had previously undergone lumbar microdiscectomy and were experiencing a new disc herniation. The patients were divided into two groups, one receiving standard revision discectomy and the other receiving revision discectomy with MIS TLIF. Various factors such as Japanese Orthopaedic Association scores, operating time, blood loss, hospital stay, costs, and complications were recorded and examined. The results showed that MIS TLIF was associated with a reduced risk of dural rupture or neural injury, lower postoperative back pain, and lower incidence of mechanical instability or recurrence compared to standard discectomy. Overall, the study suggests that MIS TLIF is an effective treatment for RLDH
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best rated spinal facility in the world
Published article
CONCLUSION: In patients with RLDH, revision microdiscectomy is effective. In comparison with conventional microdiscectomy, MIS TLIF reduces intraoperative risk of dural rupture or neural injury, postoperative incidence of mechanical instability or recurrence, and postoperative lower back pain.
Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
J Am Acad Orthop Surg. 2023 Aug 8. doi: 10.5435/JAAOS-D-23-00123. Online ahead of print.ABSTRACTOBJECTIVE: The objective of this study was to compare the clinical outcome of minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) versus standard revision diskectomy for recurrent lumbar disk herniation (RLDH).BACKGROUND: RLDH is the most common cause of redo surgery after a,
J Am Acad Orthop Surg. 2023 Aug 8. doi: 10.5435/JAAOS-D-23-00123. Online ahead of print.
ABSTRACT
OBJECTIVE: The objective of this study was to compare the clinical outcome of minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) versus standard revision diskectomy for recurrent lumbar disk herniation (RLDH).
BACKGROUND: RLDH is the most common cause of redo surgery after a microdiscectomy. Commonly, in patients without evidence of spinal instability, many surgeons would simply redo microdiscectomy, while others proceed to a redo microdiscectomy with arthrodesis. According to the literature, there is no evidence of what the best management of an RLDH would be.
METHODS: This study involved 90 patients who underwent lumbar microdiscectomy in the past and were now experiencing a new lumbar disk herniation for the first time. The patients were divided into two groups, each with 45 patients: group A received standard revision microdiscectomy, whereas group B received revision microdiscectomy with MIS TLIF.The Japanese Orthopaedic Association score, operating time, blood loss, duration of hospital stay, costs, and complications were all prospectively recorded in a database and examined. Back and leg discomfort were measured using the visual analog scale.
RESULTS: The mean total postoperative Japanese Orthopaedic Association score across the groups exhibited no statistically significant difference, nor did the preoperative clinical and epidemiological data. Although postoperative leg pain was comparable in both groups, postoperative lower back pain in group A was much worse than that in group B. Additional revision surgery was necessary for six individuals in group A. Group A had higher rates of dural rupture and postoperative neurological impairment. Group A experienced much less intraoperative blood loss, longer operation times, and postoperative hospital stays.
CONCLUSION: In patients with RLDH, revision microdiscectomy is effective. In comparison with conventional microdiscectomy, MIS TLIF reduces intraoperative risk of dural rupture or neural injury, postoperative incidence of mechanical instability or recurrence, and postoperative lower back pain.
STUDY DESIGN: Prospective, randomized, multicenter, comparative study.
PMID:37561938 | DOI:10.5435/JAAOS-D-23-00123
The London Spine Unit : best rated spinal facility in the world
Read the original publication:
Minimally Invasive Transforaminal Interbody Fusion Versus Microdiscectomy Without Fusion for Recurrent Lumbar Disk Herniation: A Prospective Comparative Study
