scholarly journals Nomograms for Predicting Recurrent Herniation in PETD with Preoperative Radiological Factors

2021 ◽  
Vol Volume 14 ◽  
pp. 2095-2109
Author(s):  
Chong Zhao ◽  
Hao Zhang ◽  
Yan Wang ◽  
Derong Xu ◽  
Shuo Han ◽  
...  
Keyword(s):  
Recurrent Herniation

Effect of Anular Closure on Disk Height Maintenance and Reoperated Recurrent Herniation Following Lumbar Diskectomy: Two-Year Data

2015 ◽  
Vol 76 (03) ◽  
pp. 211-218 ◽  
Author(s):  
Duje Vukas ◽  
Gordan Grahovac ◽  
Martin Barth ◽  
Gerrit Bouma ◽  
Milorad Vilendecic ◽  
...  
Keyword(s):  
Recurrent Herniation ◽  
Disk Height

scholarly journals Retrospective Analysis of Reoperation Rate After Standard Lumbar Discectomy and Microdiscectomy - Single Center Experience

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Vojin Kovacevic ◽  
Nemanja Jovanovic
Keyword(s):  
Lumbar Disc ◽  
Reoperation Rate ◽  
Neurological Deficits ◽  
Treatment Modalities ◽  
Single Center Experience ◽  
Group 4 ◽  
Significant Difference ◽  
Recurrent Herniation ◽  
Clinically Significant

Abstract Discectomy is a surgical procedure in the treatment of lumbar disc herniation (LDH) if sciatica or neurological deficits occur and still persist after a course of conservative therapy. Standard discectomy (SD) and microdiscectomy (MD) are still equal in curent clinical practice. Many retrospective and prospective studies have shown that there is no clinically significant difference in the functional outcome after two treatment modalities. The aim of our study was to determine whether there are differences in the incidence of reoperation after performing SD and MD. The research included 545 patients with average period of postoperative follow-up of approximately 5.75 years. Standard discectomy was performed in 393 patients (72.11%), and micro-discectomy in 152 (27.8%) patients. The total number of reoperated patients was 37/545, or 6.78%. In the SD group, the number of reoperated patients was 33/393 (8.39%) and in the MD group 4/152 or 2.63%. Statistically significant difference (p <0.05) was recorded in favor of the MD group. Although it has been proven that both SD and MD give good endpoints of treatment and similar functional recovery, the advantage is given to microdiscectomy due to statistically significantly lower rates of recurrent herniation. This result is attributed to better visualization of neural structures and pathological substrates, as well as their mutual relationship.

Outcomes of primary and recurrent inguinal hernia repair with prosthetic mesh in a single region over 15 years

2021 ◽  
Vol 103 (7) ◽  
pp. 493-495
Author(s):  
L Smith ◽  
D Magowan ◽  
R Singh ◽  
BM Stephenson
Keyword(s):  
Inguinal Hernia ◽  
Mesh Repair ◽  
Primary Repair ◽  
Prosthetic Mesh ◽  
Recurrent Inguinal Hernia ◽  
Open Approach ◽  
Symptomatic Recurrence ◽  
Single Region ◽  
Open Mesh Repair ◽  
Recurrent Herniation

Background Sutured inguinal hernia repairs are now uncommon, with evidence suggesting that those augmented with mesh are associated with a lower recurrence rate. We aimed to explore the suggestion that the established use of mesh does indeed lower the rate of operation for recurrence in a single National Health Service region. Method We collected retrospective Office of Population Censuses and Surveys coded data across one region of all primary and recurrent inguinal hernia repairs over 15 years (2004–2019). Electronic records of recurrent repairs were scrutinised to identify year and type of previous primary repair. Results In total, 7,234 repairs were performed during this time, of which 289 (4%) were for symptomatic recurrence. Operations for primary repair increased year on year (111 in 2004 to 402 in 2019). Frequency of operation for recurrent herniation declined with increasing use of mesh (8.8% in 2004 to 3.5% in 2019). The majority of repairs (73%) for recurrence were by an open approach. As opposed to an open mesh repair, a primary laparoscopic repair was associated with an earlier recurrence. Conclusions Inguinal hernia repairs are increasing in frequency but operations for later symptomatic recurrence following an open primary prosthetic mesh repair are not.

scholarly journals Revisional Percutaneous Full Endoscopic Disc Surgery for Recurrent Herniation of Previous Open Lumbar Discectomy

2011 ◽  
Vol 5 (1) ◽  
pp. 1 ◽  
Author(s):  
Kyung Hyun Shin ◽  
Ho-Guen Chang ◽  
Nam Kyou Rhee ◽  
Kwahn Sue Lim
Keyword(s):  
Lumbar Discectomy ◽  
Disc Surgery ◽  
Recurrent Herniation

scholarly journals Complications of Lumbar Disc Herniation Following Full-endoscopic Interlaminar Lumbar Discectomy: A Large, Single-Center, Retrospective Study

2017 ◽  
Vol 3 (20;3) ◽  
pp. E379-E387
Author(s):  
Jian-Cheng Zeng
Keyword(s):  
Retrospective Study ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Complication Rate ◽  
Lumbar Disc ◽  
Lumbar Discectomy ◽  
Single Center ◽  
Nerve Root Injury ◽  
Root Injury ◽  
Recurrent Herniation

Background: The new surgical procedure of full-endoscopic interlaminar lumbar discectomy (FILD) has achieved favorable effects in the treatment of lumbar disc herniation (LDH). Along with the wide range of applications of FILD, a series of complications related to the operation has gradually emerged. Objective: To describe the types, incidences, and characteristics of complications following FILD and to explore preventative and treatment measures. Study Design: Retrospective, observational study. Setting: A spine center affiliated with a large general hospital. Method: In total, 479 patients with LDH underwent FILDs that were performed by a single experienced spine surgeon between January 2010 and April 2013.Data concerning the complications were recorded. Results: All 479 cases successfully underwent the procedure. A total of 482 procedures were completed. The mean follow-up time was 44.3 months with a range of 24 to 60 months. The average patient age was 47.8 years with a range of 16 to 76 years. Twenty-nine (6.0%) related complications emerged, including 3 cases (0.6%) of incomplete decompression in which the symptoms gradually decreased following 3 – 6 weeks of conservative treatment, 2 cases (0.4%) of nerve root injury in which the patients recovered well following 1 – 3 months of neurotrophic drug and functional exercise treatment, 15 cases (3.1%) of paresthesia that gradually improved following 1 – 8 weeks of rehabilitation exercises and treatment with mecobalamin and pregabalin, and 9 cases of recurrent herniation (1.9%). The latter condition was controlled in 4 cases with a conservative method, and 5 of these cases underwent reoperations that included 3 traditional open surgeries and 2 FILDs. Furthermore, the complication rate for the first 100 cases was 18%. This rate decreased to 2.9% for cases 101 – 479. The incidence of L4-5 herniation (8.2%) was significantly greater than that of L5-S1 (4.5%). Limitations: This is a retrospective study, and some bias exists due to the single-center study design. Conclusion: FILD is a surgical approach that has a low complication rate. Incomplete decompression, nerve root injury, paresthesia, and recurrent herniation were observed in our study. Some effective measures can prevent and reduce the incidence of the complications including strict indications for surgery, a thorough action plan, and a high level of surgical skill. Key words: Complication, lumbar disc herniation, lumbar discectomy, endoscopic, inter-laminar discectomy, minimally invasive spine surgery

12 Recurrent Herniation of the Lumbar Intervertebral Disk*

1967 ◽  
Vol 52 ◽  
pp. 169-178 ◽  
Author(s):  
Joseph A. Epstein ◽  
Leroy S. Lavine ◽  
Bernard S. Epstein
Keyword(s):  
Intervertebral Disk ◽  
Recurrent Herniation ◽  
Lumbar Intervertebral Disk

scholarly journals Prevalence of Recurrent Herniation Following Percutaneous Endoscopic Lumbar Discectomy: A Meta-Analysis

2018 ◽  
Vol 1 (21;1) ◽  
pp. 337-350
Author(s):  
Huiren Tao
Keyword(s):  
Risk Factors ◽  
Disc Herniation ◽  
Retrospective Studies ◽  
Lumbar Disc ◽  
Meta Analysis ◽  
Lumbar Discectomy ◽  
Older Age ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Recurrent Herniation ◽  
Endoscopic Lumbar Discectomy

Background: Percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive surgery for the treatment of lumbar disc herniation (LDH) with a smaller incision, decreased damage to soft tissues, faster recovery, and fewer postoperative complications. However, the exactly epidemiological prevalence of recurrent herniation after PELD remains unclear. Objectives: To investigate the epidemiological prevalence of recurrent herniation in patients following PELD and to analyze the potentially related risk factors. Study Design: Meta-analysis and systematic review of prospective and retrospective studies. Methods: We conducted a comprehensive search in MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials that mentioned the incidence of recurrent herniation after PELD. The overall prevalence estimate was calculated by an appropriate meta-analysis. Subgroup analysis, sensitivity analysis, and publication bias assessment were also performed in our study, respectively. Results: Our results showed the overall prevalence of recurrent herniation after PELD was 3.6% (95% CI 3.0-4.3%). The prevalence estimates after percutaneous endoscopic interlaminar discectomy (PEID) and percutaneous endoscopic transforaminal discectomy (PETD) were 4.2% and 3.4%, respectively. Individuals with older age (≥ 50 years) and higher BMI (≥ 25) had increased recurrence rates after PELD than those with younger age (4.3% vs. 2.7%) and normal body mass index (BMI) (4.8% vs. 1.5%). The prevalence was significantly higher at upper discs (5.4%) than that at L4-5 (2.7%) and L5-S1 (3.1%) level. The incidence of recurrent herniation at lateral disc was 4.7%, and the recurrence rate of migrated herniation was 3.8%. In most cases, the recurrent herniation occurred within 6 months postoperatively (accounting for 61.7%). Limitations: A majority of the included articles were relatively low quality retrospective studies with significant heterogeneity among them. Furthermore, owing to the paucity of data focused on recurrence, many potentially predictive factors related to subgroup analyses could not be conducted, which might have influenced the accuracy and comprehensiveness of our meta-analysis. Conclusions: PELD is associated with a certain rate of recurrence (3.6%), which usually occurred within 6 months postoperatively. Older age (≥ 50 years), obesity (BMI ≥ 25), upper lumbar disc and central disc herniation might be independent risk factors for recurrence after PELD; however, different surgical approaches (PETD or PEID), lateral discs, migrated discs and foraminoplasty did not affect the incidence. These factors could be useful in preoperative evaluation, appropriate patient selection and informed consent before PELD. Key words: Percutaneous endoscopic lumbar discectomy, prevalence, recurrent herniation, meta-analysis

scholarly journals Incidence and clinical impact of vertebral endplate changes after limited lumbar microdiscectomy and implantation of a bone-anchored annular closure device

2020 ◽  
Author(s):  
Jenny Christine Kienzler ◽  
Sofia Rey ◽  
Oliver Wetzel ◽  
Hermien Atassi ◽  
Sabrina Bäbler ◽  
...  
Keyword(s):  
Multivariate Regression ◽  
Multivariate Regression Analysis ◽  
Clinical Findings ◽  
Closure Device ◽  
Vertebral Endplate ◽  
Endplate Changes ◽  
High Incidence ◽  
Recurrent Herniation ◽  
Annular Closure Device

Abstract Background: An annular closure device (ACD) could potentially prevent recurrent herniation by blocking larger annular defects after limited microdiscectomy (LMD). The purpose of this study was to analyze the incidence of endplate changes (EPC) and outcome after LMD with additional implantation of an ACD to prevent reherniation. Methods: This analysis includes data from a) RCT study-arm of patients undergoing LMD with ACD implantation and b) additional patients undergoing ACD implantation at our institution. Clinical findings (VAS,ODI), radiological outcome (reherniation, implant integrity, volume of (EPC) and risk factors for EPC were assessed. Results: Seventy-two patients (37men, 47±11.63yo) underwent LMD and ACD implantation between 2013-2016. A total of 71 (99%) patients presented with some degree of EPC during the follow-up period (14.67±4.77months). In the multivariate regression analysis, localization of the anchor was the only significant predictor of EPC (p=0.038). The largest EPC measured 4.2 cm3. Reherniation was documented in 17 (24%) patients (symptomatic: n=10; asymptomatic: n=7). Six (8.3%) patients with symptomatic reherniation underwent rediscectomy. Implant failure was documented in 19 (26.4%) patients including anchor head breakage (n=1, 1.3%), dislocation of the whole device (n=5, 6.9%), and mesh dislocation into the spinal canal (n=13, 18%). Mesh subsidence within the EPC was documented in 15 (20.8%) patients. Seven (9.7%) patients underwent explantation of the entire, or parts of the device.Conclusion: Clinical improvement after LMD and ACD implantation was proven in our study. High incidence and volume of EPC did not correlate with clinical outcome. Mechanical friction of the polymer mesh with the endplate is most likely the cause of EPC after ACD.

Sign in / Sign up

Export Citation Format

Share Document