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, 2018, 5286760
eCollection

The Frequency of Resurgery After Percutaneous Lumbar Surgery Using Dekompressor in a Ten-Year Period

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The Frequency of Resurgery After Percutaneous Lumbar Surgery Using Dekompressor in a Ten-Year Period

Stephan Klessinger. Minim Invasive Surg.

Abstract

To prevent open surgical procedures, minimally invasive techniques, like Dekompressor (PLDD), have been developed. The absence of reherniation is an important factor correlating with clinical success after lumbar surgery. In this retrospective, observational study, the frequency of additional open surgery after PLDD in a long time retrospective was examined. The correlation between clinical symptoms and outcome was assessed, and the time between PLDD and open surgery was analyzed. Consecutive patients after PLDD between 2005 and 2007 were included. MacNab's outcome criteria were used to evaluate patient satisfaction. The need for additional open surgery of the lumbar spine, the period between Dekompressor and resurgery, and the treated levels were analyzed. In total, 73 patients were included in this study. The patients were seen one month after PLDD. The majority of patients (76.7%) had additional radicular pain. The most common level treated was L4-5 (58.9%). The follow-up time was longer than 5 years in 30.1% of the patients and longer than 10 years in 6.82%. The short-term success rate was 67.1%. Additional surgery was performed in 26.0% of patients, with 78.9% of the reoperations undertaken during the first year after PLDD. These patients had a statistically significant worse outcome (P = 0.025). Radicular pain was present in all patients with an early subsequent surgery, but only in 50% of patients with late surgery (P = 0.035). Significantly more patients with poor pain relief had radicular pain (P = 0.04). The short-term success rate was worsened by a resurgery rate of 26.0%. Subsequent surgery, a short time after PLDD, suggests that PLDD is not a replacement for open discectomy. Because patients with radicular pain had a worse outcome and more frequent resurgeries, whether radicular pain is an ideal indication for PLDD should be discussed.

Figures

Figure 1
Figure 1
AP and lateral fluoroscopy image of the position of the PLDD wand at L4-5.

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