7 cases with previous surgeries and free fragments: 100% success with average of 16 weeks follow-up.

Source: IITS 2007 France


INTRODUCTION

Success rates reports in endoscopically treated recurrent disc herniations are rare to find in the literature. The purpose of the present abstract is to report 7 cases of uncontained recurrent disc herniations treated with a non-traumatic endoscopic approach.

MATERIAL AND METHODS

7 cases of patients with recurrent disc herniations and free fragments were randomly selected from our data bank. 29% were females and 71 % were males with ages ranging from 21 to 60 years old (average 40 years old). All patients had a previous laminectomy at the same level and on the same side of the current presentation. 43 % of the herniations were located at the L4/L5 level and 57 % at L5/S1 level. 4 cases were treated with a double approach, 2 with a single approach and 1 with a paramedian access. The patients were followed up on an average of 16 weeks post-surgically.

RESULTS

Utilizing the MacNab criteria results were as follows: EXCELLENT: 58% (n:4), GOOD: 42% (n:3). The SUCCESS RATE was 100%. No complications were reported.

CONCLUSIONS

Non-traumatic endoscopic approach in recurrent disc herniations with free fragments, previously treated with more invasive and traumatic surgical procedures, is a safe and very effective method of treatment. The presence of scar tissue from a previous procedure doesn't seem to have an impact on the outcome. However, a larger population should be studied before getting to a more definitive conclusion.

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