RESEARCH ARTICLE


Minimum Two-Year Follow-Up of Cases with Recurrent Disc Herniation Treated with Microdiscectomy and Posterior Dynamic Transpedicular Stabilisation



Tuncay Kaner*, 1, Mehdi Sasani2, Tunc Oktenoglu2, Ahmet Levent Aydin3, Ali Fahir Ozer2
1 Pendik State Hospital, Neurosurgery Department, Istanbul, Turkey
2 American Hospital, Neurosurgery Department, Istanbul, Turkey
3 Istanbul Physical Therapy and Rehabilitation Training Hospital, Neurosurgery Department, Istanbul, Turkey


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Creative Commons License
© Kaner et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/)which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Neurosurgery, Pendik State Hospital, Pendik, Istanbul, Turkey; Tel: (90) 216 4644800; Fax: (90) 216 4644801; E-mail: tkaner2002@yahoo.com


Abstract

The objective of this article is to evaluate two-year clinical and radiological follow-up results for patients who were treated with microdiscectomy and posterior dynamic transpedicular stabilisation (PDTS) due to recurrent disc herniation. This article is a prospective clinical study. We conducted microdiscectomy and PDTS (using a cosmic dynamic screw-rod system) in 40 cases (23 males, 17 females) with a diagnosis of recurrent disc herniation. Mean age of included patients was 48.92 ± 12.18 years (range: 21-73 years). Patients were clinically and radiologically evaluated for follow-up for at least two years. Patients’ postoperative clinical results and radiological outcomes were evaluated during the 3rd, 12th, and 24th months after surgery. Forty patients who underwent microdiscectomy and PDTS were followed for a mean of 41 months (range: 24-63 months). Both the Oswestry and VAS scores showed significant improvements two years postoperatively in comparison to preoperative scores (p<0.01). There were no significant differences between any of the three measured radiological parameters (α, LL, IVS) after two years of follow-up (p > 0.05). New recurrent disc herniations were not observed during follow-up in any of the patients. We observed complications in two patients. Performing microdiscectomy and PDTS after recurrent disc herniation can decrease the risk of postoperative segmental instability. This approach reduces the frequency of failed back syndrome with low back pain and sciatica.

Keywords: Lumbar spine, recurrent disc herniation, decompression, posterior dynamic stabilisation, segmental instability, adjacent level diseases.