Message wise — Doctors at RUDN University compared the classic approach to surgical treatment of recurrent intervertebral hernias with a modified one. The traditional technique is to simply remove the disc; During the modified operation, the vertebrae are then joined together. The first option is cheaper, but the second eliminates the risk of relapse. The results were published in Annals of Medicine and Surgery.

Destruction of the intervertebral disc can lead to an intervertebral herniation – the protrusion of the disc nucleus into the intervertebral canal. Hernias do not always require surgery, but a discectomy is usually performed if necessary. The intervertebral disc is removed in whole or in part. However, a few months after the discectomy, the hernia may recur to the same extent. In this case, a new discectomy can be performed. Current studies demonstrate the effectiveness of a spinal fusion method in which the vertebral bodies are connected to each other with plates and screws after the intervertebral disc has been removed. The purpose of this operation is to limit the mobility of the vertebrae. RUDN doctors compared the results of a classic repeat discectomy and spinal fusion.

“Repeated discectomy is widely recommended due to its minimal invasiveness, rapid patient recovery, and low surgical cost. However, there is a risk of recurrence and vertebral instability. Spinal fusion is more expensive and requires a longer hospital stay. We compared the postoperative outcomes in patients who underwent repeat discectomy with and without spinal fusion,” said Musa Gerald, assistant in the Department of Neurology and Neurosurgery with a comprehensive rehabilitation course at RUDN University.

The study was conducted retrospectively on 74 patients with recurrent lumbar disc herniation from 2018 to 2023. Forty patients underwent discectomy without spinal fusion, and the remaining 34 underwent spinal fusion. To ensure that patients had a similar degree of disease, they were selected based on radiographs taken before surgery. Spinal fusion was prescribed to patients with severe vertebral instability if the displacement was more than 4 mm or the angle of inclination exceeded 10°. All patients had previously undergone a discectomy and had no symptoms for at least one month afterwards.

A discectomy results in less blood loss – an average of 88.75 ml compared to 111.47 ml for a spinal fusion. However, the latter showed better results in the ODI back pain score – 4.21 instead of 9.27 for discectomy. Finally, 22% of patients experienced recurrent herniation after repeat discectomy. No recurrent cases at all were noted after spinal fusion.

“Spinal fusion and repeat discectomy for recurrent lumbar disc herniation are comparable in terms of blood loss during surgery, duration of the surgery itself, and hospital stay. However, a spinal fusion is easier to tolerate in terms of pain than a discectomy. This is associated with instability in discectomy patients. After spinal fusion, these processes are eliminated and slowed down, no relapses have been observed,” said Musa Gerald, assistant of the Department of Neurology and Neurosurgery with a comprehensive rehabilitation course at RUDN University.

By admin

Leave a Reply

Your email address will not be published. Required fields are marked *