gms | German Medical Science

129. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

24.04. - 27.04.2012, Berlin

Same-level recurrent lumbar disc herniation complicates outcome after primary discectomy in a subset of patients, occurs in 10% of patients and is associated with substantial health care costs. Study results reveal operation induced destabilisation due to necessary resection of spinal canal structures without using minimal invasive procedures if possible. We present the clinical characteristics, the long term follow up including new X-ray and CT Scans of the lumbar spine and the neurological status of 14 consecutive patients treated with percutaneous pedicle screw and rod fixation with minimally invasive lumbar interbody fusion in recurrent lumbar disc herniation and Modic type I or II erosive osteochondrosis.

Meeting Abstract

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  • Mario Leimert - Uniklinik Dresden, Neurochirurgie, Dresden
  • Julia Neidel - Uniklinik Dresden, Neurochirurgie, Dresden

Deutsche Gesellschaft für Chirurgie. 129. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 24.-27.04.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12dgch195

DOI: 10.3205/12dgch195, URN: urn:nbn:de:0183-12dgch1954

Veröffentlicht: 23. April 2012

© 2012 Leimert et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: We present the clinical characteristics, the long term follow up including new X-ray and CT Scans of the lumbar spine and the neurological status of 14 consecutive patients treated with percutaneous pedicle screw and rod fixation with minimally invasive lumbar interbody fusion in recurrent lumbar disc herniation and Modic type I or II erosive osteochondrosis.

Materials and methods: We reviewed the charts, patient records, X-Ray, CT-scan and MRI of the lumbar spine, operative reports and clinical notes of our patients with recurrent lumbar disc herniations and erosive osteochondrosis between 2007 and 2010 and obtained the late follow up with a clinical questionnaire and neurological examination (VAS, Oswestry Disability Index, MacNab criteria) within the spine unit and carried out new X-Ray and or CT Scan of the lumbar spine. Data collection was completed in n=14 of 14 operated patients (median follow up: 12 months; 3–30 months; mean age 54 years; 44–60 y; 6 female and 8 male; at least 2nd recurrent herniation of lumbar disc). Clinical and radiographic assessment using standard scales was acquired prospectively in pre-defined time intervals (VAS, Oswestry-Score, MacNab criteria).

Results: 14 patients (6 female, 8 male) with a mean age at presentation of 54 years (range 40–60) have undergone single level percutaneous pedicle screw and rod insertion and minimally invasive lumbar interbody fusion L4/L5 or L5/S1 at our institution between 2007 and 2010. Median operation time: 190 min (150–230 min), with an average X-ray exposure time of 3.35 min (1.5 to 5.5 min). Significant postoperative pain relief and mobility improvement could be documented with the VAS (69 to 30) and the Oswestry Disability Index (68% to 24%).

Conclusion: Percutaneous Pedicle Screw and Rod Fixation with minimally invasive lumbar interbody fusion is a gentle, soft tissue, nerve protecting and safe procedure for lumbar fixation with a good stabilizing effect and fusion rates comparable to conventional more invasive techniques.