Packing of intervertebral spaces with oxidized regenerated cellulose to prevent the recurrence of lumbar disc herniation.
OBJECTIVE
To investigate the impact of packing of intervertebral spaces with oxidized regenerated cellulose (ORC) on the incidence of recurrence of lumbar disc herniation (LDH).


METHODS
We retrospectively reviewed 158 consecutive patients who underwent surgery for a newly diagnosed LDH and had a minimum of 18 months of follow-up. Single-level (151 patients) and two-level (7 patients) procedures accounted for 165 microdiscectomies. After microsurgical removal of disc herniation and curettage, the interspaces were tightly packed with ORC.


RESULTS
The average hospital stay was 1.47 days, without any relevant and permanent complications. In particular, complications related to intervertebral ORC packing were never observed. At a median follow-up of 29 months (range, 18-51 mo), the pain decreased or disappeared in almost all patients and the patient satisfaction rate was very high. A recurrence of LDH was observed in two patients (1.34%), both of whom needed a second operation. Three patients (2.01%) experienced a disc herniation involving another intervertebral space.


CONCLUSIONS
Our preliminary results suggest that the packing of intervertebral spaces with ORC at the end of microdiscectomy is a safe technique that may reduce the incidence of recurrent LDHs, although the true impact of this technique on long-term follow-up is still unclear. At the moment, it seems reasonable to assume that this technique should be used only under the auspices of large clinical investigations with prospective and randomized protocols.
Mastronardi
Luciano
L
Division of Neurosurgery, Sandro Pertini Hospital, Rome, Italy. mastro@tin.it
Puzzilli
Fabrizio
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002483:Cellulose, Oxidized / Q000627:therapeutic use*; D017586:Diskectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000517:prevention & control* / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D012189:Retrospective Studies; D055502:Secondary Prevention; D013997:Time Factors
D002483:Cellulose, Oxidized; D006490:Hemostatics