Role of microendoscopic discectomy for the treatment of recurrent lumbar disc herniation: A retrospective review

Abstract

Background: Recurrent herniation following lumbar disc excision has been reported in 5–11% of patients. There are very few studies on role and outcomes of minimally invasive techniques for the treatment of recurrent disc herniation.Study Design: A retrospective analytical study of 22 patients with recurrent lumbar disc herniation treated with minimally invasive techniques.Objectives: To analyze the role and scope of minimally invasive surgical techniques and consequent outcome in various cases of recurrent lumbar disc herniation.Method: Total 22 patients with recurrent lumbar disc herniations who underwent operations in the form of microendoscopic discectomy (MED) were studied for a period of 1 year. These cases of recurrent lumbar disc herniation with the perioperative data and clinical outcomes (according to modified Macnab criteria) upto 1 year follow up were compared with the previously published data.Results: Overall, the clinical outcomes were significantly excellent or good during and at 1 year follow-up. No case had to be converted to open procedure. Complications occurred in three cases including one incidental durotomy and two patients had recurrent disc herniation. No other significant morbidity including wound infection, neural injury or residual instability occurred till last follow-up. Operative duration, blood loss, complication rate and overall outcomes were statistically comparable to the previously published data.Conclusions: This study suggests that outcomes of minimally invasive techniques for treating recurrent lumbar disc herniation are equivalent to or even superior in some cases in which conventional open surgery was considered. The operative time, blood loss and complications of patients treated with revision MED were comparable to the previously published data. The procedure appears to be a safe and effective alternative with significant improvement in pain, disability, and faster return to work in case of recurrent lumbar disc herniation.