Lumbar discectomy with annulus fibrosus closure: A retrospective series of 53 consecutive patients |
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Affiliation: | 1. Department of Neurosurgery, Hôpital du Valais, Centre Hospitalier du Valais Romand, Hôpital de Sion;2. Department of Clinical Neurosciences, Neurosurgery Service and Gamma Knife Center, Lausanne University Hospital (CHUV);3. Faculty of Biology and Medicine (FBM), University of Lausanne (Unil), Lausanne, Switzerland;4. Signal Processing Laboratory (LTS 5), Ecole Polytechnique Fédérale de Lausanne (EPFL) |
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Abstract: | IntroductionLumbar disc herniation is most common degenerative alteration of the spine. Whenever surgical therapy proves to be necessary, recurrent disc herniation is most frequent concern. Here, primary aim was to determine the percentage of patients eligible for insertion of an annular closure device (ACD). Secondary aim to evaluate 12-month incidence of recurrent disc herniation at the operated level. Our hypothesis was that ACD might help in preventing recurrent disc herniation.MethodsPatients in a single Swiss neurosurgical center underwent limited discectomy alone (n = 41, group 1) versus limited discectomy plus ACD (n = 12, group 2). Mean postoperative follow-up period was 12 months.ResultsTwelve out of 53 patients (22.6%) were eligible for ACD implantation. Patients of group 2 were significantly taller (mean 176 cm, P = 0.007) as compared with group 1 (mean 170). The only statistically significant difference of intraoperative parameters between group 1 and 2 was amount of nucleus materiel removed (P = 0.01), being greater in group 2 (mean 0.9) as compared with group 1 (mean 0.3). In group 1 six patients (6/41, 14.6%) presented with symptomatic reherniation at same level of surgery, while in group 2 only one patient experienced recurrence (1/12, 8.3%). No adverse events were reported.DiscussionIn the current study one out of five patients with lumbar disc herniation was considered suitable for ACD placement. In vast majority of these patients reherniation was precluded on the short-term basis. Patients with ACD were taller and had intraoperatively a higher volume of the nucleus pulposus materiel removed. |
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Keywords: | Hernia Lumbar Discal Reherniation Annular closure device Barricaid® Hernie Lombaire Discale Reherniation Annular closure device Barricaid® |
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