The Surgical Outcome and the Surgical Strategy of Percutaneous Endoscopic Discectomy for Recurrent Disk Herniation

Abstract

The relevant utilization of updated surgical techniques may be helpful in overcoming the difficulty of revision surgery.

Our Experience with 67 Cases of Percutaneous Transforaminal Endoscopic Lumbar Discectomy

“…Fusion surgery was required only in 1 patient. The dural injury risk in microendoscopic discectomy has been reported to be higher than in microsurgery [20,22]. Ruetten et al [23] reported in their article that satisfactory results were obtained in 90% of their patients, with a re-recurrence rate of 5.7% and no difference with open surgery.…”

“…The use of foraminoplasty in discs with marked migration increases the surgical success rate. However, it is reported that disc remnants can be seen in 5-13% of cases and post-operative temporary dysesthesia in up to 13% of cases, even in experienced hands [20,21]. Another disorder where PELD has become popular recently is recurrent disc herniation.…”

“…Hoogland et al [16] reported a mean pre-operative VAS of 8.2 and a mean post-operative VAS of 2.6 in a series of 142 cases. Kim et al [20] reported a success rate of 81% according to the MacNab criteria in 26 recurrent disc hernias that underwent endoscopic surgery. The mean preoperative VAS was 7.8 ± 1.8 and the mean post-operative VAS 2.5± 2.6.…”

“…The re-recurrence rate was reported as 4.6% by Hoogland et al [17]. Severe complications in open surgery were emphasized as being more common than in endoscopic surgery [17,20]. Despite the increase in surgical experience and developments in technology, re-operation rates vary between 5.7% and 24% [23,24].…”

“…Another disorder where PELD has become popular recently is recurrent disc herniation. Kim et al [20] recommend PELD as an alternative method for recurrent disc hernias. They report that re-traumatization of the posterior spinal elements and problems due to scar tissue can be prevented in this way.…”