Objective: The most common complication after lumbar discectomy is reherniation. Although many studies have investigated factors that may increase the reherniation risk, few are agreed upon all. It has been suggested that limited nucleus removal is associated with higher reherniation risk, while more aggressive nucleus removal can result in increased disc degeneration. Here, we assessed the efficacy of a coblation-assisted microdiscectomy in adult patients undergoing single-level disc surgery. Methods: We prospectively compared the reherniation rate in 75 patients (Group 1) undergoing single-level lumbar disc surgery completed with the radiofrequency bipolar system Aquamantys® (Medtronic, Minneapolis, MN, USA) to that of a historical control group (n = 75) matched for variables related to herniation level and characteristics (Group 2). Patients were followed up to 4 years. Reherniations were assessed, pain and function were monitored throughout, and imaging was performed at annual follow-up. Results: The overall symptomatic reherniation rate was 4%. In particular, one case (1.3%) was observed in Group 1 and five (6.7%) in Group 2 (P < 0.05). Magnetic resonance imaging identified a total of 4 (2.7%) asymptomatic reherniations at 12 months, 6 (4%) at 24 and 36 months, and 7 (4.7%) at 48 months. Overall, Group 1 contained one (1.3%) asymptomatic reherniation case, while six (8%) were observed in Group 2 (P < 0.05). Conclusions: The low reherniation rate in patients treated by the coblation-assisted microdiscectomy suggests that this technique may reduce the reherniation risk. Clinical outcomes for pain and function at 4 years follow-up compared favorably with literature data. Randomized controlled trial could confirm these results. © 2019 Journal of Craniovertebral Junction and Spine.

Grasso, G., Torregrossa, F., Landi, A. (2019). Prevention of lumbar reherniation by the intraoperative use of a radiofrequency bipolar device: A case-control study. JOURNAL OF CRANIOVERTEBRAL JUNCTION AND SPINE, 10(2), 94-99 [10.4103/jcvjs.JCVJS_47_19].

Prevention of lumbar reherniation by the intraoperative use of a radiofrequency bipolar device: A case-control study

Grasso, G.
;
2019-01-01

Abstract

Objective: The most common complication after lumbar discectomy is reherniation. Although many studies have investigated factors that may increase the reherniation risk, few are agreed upon all. It has been suggested that limited nucleus removal is associated with higher reherniation risk, while more aggressive nucleus removal can result in increased disc degeneration. Here, we assessed the efficacy of a coblation-assisted microdiscectomy in adult patients undergoing single-level disc surgery. Methods: We prospectively compared the reherniation rate in 75 patients (Group 1) undergoing single-level lumbar disc surgery completed with the radiofrequency bipolar system Aquamantys® (Medtronic, Minneapolis, MN, USA) to that of a historical control group (n = 75) matched for variables related to herniation level and characteristics (Group 2). Patients were followed up to 4 years. Reherniations were assessed, pain and function were monitored throughout, and imaging was performed at annual follow-up. Results: The overall symptomatic reherniation rate was 4%. In particular, one case (1.3%) was observed in Group 1 and five (6.7%) in Group 2 (P < 0.05). Magnetic resonance imaging identified a total of 4 (2.7%) asymptomatic reherniations at 12 months, 6 (4%) at 24 and 36 months, and 7 (4.7%) at 48 months. Overall, Group 1 contained one (1.3%) asymptomatic reherniation case, while six (8%) were observed in Group 2 (P < 0.05). Conclusions: The low reherniation rate in patients treated by the coblation-assisted microdiscectomy suggests that this technique may reduce the reherniation risk. Clinical outcomes for pain and function at 4 years follow-up compared favorably with literature data. Randomized controlled trial could confirm these results. © 2019 Journal of Craniovertebral Junction and Spine.
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85069220436&doi=10.4103/jcvjs.JCVJS_47_19&partnerID=40&md5=27842b43950663b9d42e31a4b83554bd
Grasso, G., Torregrossa, F., Landi, A. (2019). Prevention of lumbar reherniation by the intraoperative use of a radiofrequency bipolar device: A case-control study. JOURNAL OF CRANIOVERTEBRAL JUNCTION AND SPINE, 10(2), 94-99 [10.4103/jcvjs.JCVJS_47_19].
File in questo prodotto:
File Dimensione Formato  
JCraniovertJunSpine_2019_10_2_94_262791.pdf

accesso aperto

Tipologia: Versione Editoriale
Dimensione 1.4 MB
Formato Adobe PDF
1.4 MB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10447/413167
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 5
  • ???jsp.display-item.citation.isi??? 5
social impact