NDLI: Minimally invasive tubular microdiscectomy for recurrent lumbar disc herniation: step-by-step technical description with safe scar dissection

Content Provider	Springer Nature : BioMed Central
Author	AlAli, Khaled Fares
Abstract	Introduction Recurrent lumbar disc herniation (RLDH) is one of the most common reasons for re-operation after primary lumbar disc herniation with an incidence ranging from 5 to 23%. Numerous RLDH studies have been conducted; however, no available studies have provided a specific description of the use of the tubular retractor discectomy technique for RLDH emphasizing safe scar dissection. The objective of this study is to describe a detailed step-by-step technique for RLDH. Material and methods A surgical technique reporting on our experience from the year 2013–2021 in 9 patients with RLDH at the same level and same side was included in the study. Clinical outcomes were assessed using the visual analog score (VAS) for leg pain before and three months after surgery. Results A significant improvement was observed between the preoperative and postoperative VASs [mean (SD): 9.2 (1) vs. 1.5 (1)] for all patients. We did not report any incidental durotomy, neurological deficits or mortality in this study. One patient had superficial wound infection. The study is limited by small population, short follow-up and not reporting stability or spondylolisthesis. Conclusion A modified tubular discectomy technique with safe scar dissection is effective for RLDH treatment. Technically, the only scar needed to be dissected is the scar lateral to the exposed normal dura and the scar extended caudally till the level of the superior end plate of the targeted disc space where the scar can be entered ventrally and the disc fragment retrieved. Adherence to the step-by-step procedure described in our study will help surgeons operate with more confidence and minimize complications of recurrent lumbar disc herniation.
Related Links	https://josr-online.biomedcentral.com/counter/pdf/10.1186/s13018-023-04226-1.pdf
Ending Page	14
Page Count	14
Starting Page	1
File Format	HTM / HTML
DOI	10.1186/s13018-023-04226-1
Journal	Journal of Orthopaedic Surgery and Research
Issue Number	1
Volume Number	18
Language	English
Publisher	BioMed Central
Publisher Date	2023-10-05
Access Restriction	Open
Subject Keyword	Orthopedics Surgical Orthopedics Recurrent lumbar disc herniation Scar Durotomy Minimally invasive spine
Content Type	Text
Resource Type	Article
Subject	Surgery Orthopedics and Sports Medicine
Journal Impact Factor	2.8/2023
5-Year Journal Impact Factor	3/2023

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