Minimally invasive transforaminal lumbar interbody fusion (TLIF) for the surgical management of post-discectomy syndrome /
الجراحة الأقل اختراقـا للجلد لالتحام الفقرات خلال الثقب الفقارى القطنى فى العلاج الجراحى لمضاعفات ما بعد استئصال الغضروف القطنى
Ahmed Bahaa Aldin Alshazli ; Supervised Yasser Elmiligui , Wael Tawfeek Koptan , Ahmed Maher Sultan
- Cairo : Ahmed Bahaa Aldin Alshazli , 2017
- 187 P. : charts , facsimiles ; 25cm
Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Orthopedic Surgery
Post-discectomy syndrome is a common cause of back or limb pain following discectomy procedures. About 0.5-25% develops recurrent disc herniation (rDH) after a successful first discectomy. Currently, there arent any guidelines to assist surgeons in determining which approach is most appropriate to treat post-discectomy syndrome. A recent survey showed significant heterogeneity among surgeons regarding treatment options for rDH. It remains unclear which methods lead to better outcomes, as there are no comparative studies with a sufficient level of evidence. Methods: In this study we treated 30 patients with failed discectomy surgery and met our inclusion criteria with minimal invasive (MI) TLIF. Patients were followed up for improvement of symptoms with VAS, ODI. Also interbody fusion rate was assessed using CT scan at 6 month and one year follow up. Finally we compared our result to different conventional open modalities of treatment in literature. Results: The ODI for all patients showed significant improvement (mean 31.5% one 1 postoperative and mean 16.7% at 6 months postoperative). The preoperative VAS score of LBP (mean 3.2) showed statistically insignificant decrease of values in early postoperative period. Significant decrease one month post-operative (reaching 0.3 at 12th month follow-up). Preoperative VAS score of limb pain (mean 9.03) showed statistically significant decrease of values starting of immediate postoperative period with mean 2.7 reaching 0.3 at 12th month follow-up