Clinical outcomes after minimal-access surgery for recurrent lumbar disc herniation.
OBJECTIVE
Experience with minimal-access surgical approaches for revision lumbar surgery has not been previously reported.


METHODS
During a 7-month period, 10 consecutive patients with recurrent disc herniations underwent revision operations in which microendoscopic discectomy (MED) was performed. Perioperative data and clinical outcomes (according to Macnab criteria) were compared with those obtained in 25 consecutive patients who underwent routine single-level MED as well as with previously published data. Overall, outcome of the MED-treated revision group was excellent or good in 90% during a mean follow-up period of 18.5 months (minimum 12 months). Operative blood loss, duration, complications, and length of hospital stay were not significantly different between the revision and primary MED-treated groups.


CONCLUSIONS
Analysis of these early data suggests equivalent or superior results are obtained when performing MED compared with historical controls in which conventional surgery was conducted for recurrent disc surgery. The procedure appears to be a safe and effective alternative in cases in which recurrent lumbar disc herniation causes radiculopathy.
Le
Hoang
H
Section of Neurosurgery, University of Chicago Hospital, Chicago, Illinois 60637, USA.
Sandhu
Faheem A
FA
Fessler
Richard G
RG
D000328:Adult; D019299:Decompression, Surgical / Q000379:methods; D017586:Diskectomy / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D009408:Nerve Compression Syndromes / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery; D011446:Prospective Studies; D012008:Recurrence; D012086:Reoperation; D013126:Spinal Nerve Roots; D013353:Subdural Effusion / Q000209:etiology; D016896:Treatment Outcome