Recurrent Disc Prolapsed: Is the Endoscopic Approach Useful? Our Experience by Leonello Tacconi in Juniper Publishers in Open Access Journal of Neurology & Neurosurgery
Introduction:
Surgery for lumbar disc prolapse either way is performed (by an open midline microdiscectomyor a MIS technique) has a recurrence rate which varies from 5% to 18% i and in the majority of cases ends with a new operation [1]. The standard surgical technique for a recurrent disc prolapse implies a minimal mount of bony removal and most important, it is generally necessary to work through a scar tissue in order to reach the offended nerve root. Therefore there is a higher possibility of complication like CSF leak, neurological deficits, mechanical instability and postoperative pain.
With the introduction of the endoscopic technique in the neurosurgical field, many surgeons have started to treat recurrent disc, already operated on by a standard microsurgical approach, with the use of the endoscope [2]. With this technique it is possible to reach the pathology via a "virgin route" avoiding the time consuming and the dangerous scar tissue dissection.
In our Unit we have started to implement the endoscope in disk prolapse in 2015 and only after we have overcome the learning curve phase we have applied this technique also for recurrent disc. We present our experience on 17 recurrent disc cases operated on by endoscopic technique. The results, complication, as well as our philosophy to approach recurrent lumbar disc will be discussed.
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