Effectiveness of an Annular Closure Device to Prevent Recurrent Lumbar Disc Herniation

Abstract

Key Points Question In patients at high risk for lumbar disc reherniation owing to a large annular defect following lumbar microdiscectomy, does implantation with an annular closure device reduce the risk of reherniation and reoperation? Findings In this secondary analysis of a randomized clinical trial of 554 patients with large annular defects following lumbar microdiscectomy for symptomatic lumbar disc herniation, the addition of an annular closure device statistically significantly reduced the risk of symptomatic reherniation (18.8% vs 31.6%) and reoperation (16.0% vs 22.6%) through 5 years follow-up with no statistical difference in the risk of serious adverse events. Meaning These findings suggest that the use of an annular closure device may reduce the risk of symptomatic reherniation and reoperation in patients with large annular defects following lumbar microdiscectomy.

Protocol for treating lumbar spinal canal stenosis with a combination of ultrapurified, allogenic bone marrow-derived mesenchymal stem cells and in situ-forming gel: a multicentre, prospective, double-blind randomised controlled trial

“…All procedures will involve an AF incision of 5 mm × 5 mm 13. Because patients with large annular defects following discectomy are at increased risk for symptomatic recurrence and reoperation and incision size may affect postoperative outcomes,29 the size of the incision will be standardised. In patients with a transligamentous extrusion-type or sequestration-type herniated disc, the AF opening will be measured and reported 13.…”

Mechanical characterization and design of biomaterials for nucleus pulposus replacement and regeneration

“…131 Since various biomaterials have been developed for AF closure, it may be worth attempting to combine such devices alongside existing NP implant materials to best achieve overall restorative performance. [133][134][135]…”

Repair Strategies and Bioactive Functional Materials for Intervertebral Disc

“…In patients with a large defect in the AF and a high risk of hernia recurrence, the use of a bone-anchored implant for circular closure reduces the risk of reoperation and hernia recurrence. [85] Prezerakos et al evaluated the safety, clinical effects, and radiological features of the treatment of degenerative cervical radiculopathy using a novel compressible cervical disc prosthesis. The preoperative index of movement ranged from 7.9° to 7.6° at two years.…”