Comparison of lumbar discectomy alone and lumbar discectomy with direct repair of pars defect for patients with disc herniation and spondylolysis at the nearby lumbar segment

Lee, Gun Woo; Ryu, Ji Hyun; Kim, Jae Do; Ahn, Myun Whan; Kim, Ho-Joong; Yeom, Jin Sup

doi:10.1016/j.spinee.2015.06.006

Cited by 2 publications

(3 citation statements)

References 25 publications

(44 reference statements)

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“…[14][15][16] Only one report published to date has investigated the effect of spondylolysis on surgical outcomes after lumbar discectomy. 7 In that study, 48 patients underwent open discectomy alone, and 41 patients underwent open discectomy in combination with direct repair of a pars defect associated with spondylolysis. Among patients who underwent discectomy alone, the gap distance of the pars defect worsened postoperatively and surgical outcomes were inferior.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…A previous study of patients with disc herniation and spondylolysis at the same or adjacent level demonstrated inferior results after discectomy without fusion compared with decompression and direct repair of the isthmic spondylolysis. 7 However, considering that most cases of lumbar spondylolysis are asymptomatic 8,9 and that minimally invasive decompression is associated with less slip progression in patients with degenerative spondylolisthesis, 10 we speculated whether surgery to repair spondylolysis may be unnecessary in patients with apparent disc herniation and sciatica. Microendoscopic discectomy (MED) is a minimally invasive technique for LDH that preserves posterior supporting muscles.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Is Microendoscopic Discectomy Effective for Patients With Concomitant Lumbar Disc Herniation and Spondylolysis?

Oshima

Inanami²,

Iwai³

et al. 2019

Global Spine Journal

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Study Design: A retrospective cohort study. Objective: Although it is controversial whether to choose only discectomy or fusion surgery in patients with disc herniation and spondylolysis, we expected that aggravation of the spondylolysis may be prevented if posterior supporting muscles can be wellpreserved without extensive exploration. The purpose of this study was to investigate the influence of L5 spondylolysis on surgical outcomes following microendoscopic discectomy (MED) in patients with concomitant lumbar disc herniation and spondylolysis. Methods:We reviewed 811 patients who underwent MED for L4/5 or L5/S1 disc herniation. Patients with spondylolisthesis were excluded. We compared surgical outcomes of patients with and without L5 spondylolysis, whose age, sex, and surgical level were matched.Results: A total of 655 patients (80.7%) with complete data were considered eligible for the study. MED was performed at L4/5 and L5/S1 in 338 and 317 patients, respectively. A total of 20 patients (3.1%) had concomitant L5 spondylolysis and disc herniation at L4/5 (9 patients) or L5S1 (11 patients). As we compared each outcome of the 20 patients having L5 spondylolysis with 40 matched patients without L5 spondylosis, there were no significant differences in preoperative or postoperative outcomes between the 2 groups, and no patient with spondylolysis had undergone additional surgery during the mean follow-up period of 24 months.Conclusions: MED demonstrated good surgical results regardless of the presence or absence of spondylolysis. In patients with sciatica with concomitant disc herniation and spondylolysis, but without spondylolisthesis, fusion surgery may not be always necessary.

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