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KMID : 1189320200140020148
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Asian Spine Journal
2020 Volume.14 No. 2 p.148 ~ p.156
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Minimally Invasive Transforaminal Lumbar Interbody Fusion for the Surgical Management of Post-Discectomy Syndrome
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Al Shazli Ahmed Bahaa Al Din
Amer Ashraf Yassin
Sultan Ahmed Maher
Barakat Ahmed Samir
Koptan Wael
El Miligui Yasser
Shaker Hesham
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Abstract
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Study Design: This was a prospective case series of 30 patients with post-discectomy syndrome with an average of 18 months of follow-up (level IV).
Purpose: The efficacy of post-discectomy syndrome managed by minimally invasive surgery transforaminal lumbar interbody fusion (MIS-TLIF) was evaluated.
Overview of Literature: In post-discectomy syndrome wherein conservative treatment had failed, the best surgical treatment modality still remains controversial.
Methods: Patients were functionally assessed using the Visual Analog Scale (VAS) for low back pain (LBP) and leg pain (LP) and Oswestry Disability Index (ODI). Radiological fusion was confirmed with plain X-rays and when indicated with computed tomography scan at 12 months postoperatively. A total of 30 patients with 37 operated at lumbar levels with failed discectomy surgery who met our inclusion criteria were treated with MIS-TLIF.
Results: The ODI of all patients showed significant improvement from a mean of 73.78% preoperatively to 16.67% at 1 month and 14.13% at 12 months postoperatively. The preoperative LBP VAS score (mean, 4.37) showed a significant decrease (p<0.001) to 1.90 at 1 month and 1.10 at 12 months. Preoperative LP VAS score of limb pain averaged 7.53 and showed a significant (p<0.001) decrease to 3.47 at 1 month and 1.10 at 12 months. All patients attained radiological fusion at 12 months.
Conclusions: MIS-TILF constitutes a valid and effective treatment option for patients with post-discectomy syndrome.
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KEYWORD
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Post-diskectomy syndrome, Failed back surgery, Recurrent disc prolapse, Interbody fusion, Minimally invasive surgery transforaminal lumbar interbody fusion
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