Value of Using Interbody Fusion Technique in Recurrent Lumbar Disc Hernia Patients

Abstract

Background: The aim of this study is to compare the clinical and functional outcomes of recurrent lumbar disc herniation (RLDH) revision surgery by either rediscectomy alone or rediscectomy with transforaminal lumbar interbody fusion (TLIF).Methods: This prospective study was performed between August 2018 and August 2019. Twenty patients were surgically treated for recurrent lumbar disc herniation at the Department of Spine Surgery, Zagazig University Hospitals, and Nasser Institute Hospital. Ten patients underwent rediscectomy (Group A) and the other ten patients underwent rediscectomy with TLIF (Group B) with exclusion to any other pathologies (multisegmental spinal canal stenosis, adjacent level disc herniation, spondylolisthesis, spinal instability, spinal deformities, and tumors).Results: Results showed no significant difference between the two groups on clinical outcomes, but there was a significant improvement in clinical outcomes in both groups postoperatively. Regarding time till return to work, There was a statistically significant difference between the two studied groups regarding the time till return to work with shorter time among the rediscectomy group than the rediscectomy with TLIF group (2.1±0.7versus3.4±0.8, p-value=0.002).Conclusion: We concluded that patients without signs of spinal instability and/or severe back pain who suffer from leg pain will benefit from rediscectomy surgery in first time recurrence of herniation with no further benefits from re-discectomy with TLIF over re-discectomy alone in short term follow up.