Minimally Invasive Transforaminal Lumbar Interbody Fusion for the Surgical Management of Post-Discectomy Syndrome

Abstract

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.

Keywords

• post-diskectomy syndrome
• failed back surgery
• recurrent disc prolapse
• interbody fusion
• minimally invasive surgery transforaminal lumbar interbody fusion