Surgical Experience and Complications in 50 Patients Treated with an Anular Closure Device Following Lumbar Discectomy.
Adult
Aged
Annulus Fibrosus
/ surgery
Diskectomy
/ instrumentation
Female
Follow-Up Studies
Humans
Intervertebral Disc Displacement
/ prevention & control
Intraoperative Complications
/ epidemiology
Lumbar Vertebrae
/ surgery
Male
Middle Aged
Postoperative Complications
/ epidemiology
Prospective Studies
Recurrence
Reoperation
Secondary Prevention
/ instrumentation
Anular closure
Lumbar discectomy
Microdiscectomy
Reherniation
Journal
Orthopaedic surgery
ISSN: 1757-7861
Titre abrégé: Orthop Surg
Pays: Australia
ID NLM: 101501666
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
received:
14
01
2018
revised:
06
05
2018
accepted:
19
06
2018
entrez:
28
6
2019
pubmed:
28
6
2019
medline:
9
1
2020
Statut:
ppublish
Résumé
To examine the results of an anular closure device for prevention of lumbar disc reherniation in daily routine practice. Fifty patients with large anular defects were treated with limited discectomy and a bone-anchored anular closure device. The device physically occludes the defect in the anulus fibrosus and is intended for prevention of lumbar disc reherniation. Pain scores on a visual analogue scale, back function on the Oswestry Disability Index, and neurological status were noted. Symptomatic reherniation and reoperation rates were assessed at each follow-up. Surgical findings and complications, device-related and/or procedure-related, were recorded. Follow-up was 6, 12, 26, and 52 weeks. Mean anular defect height/width was 4.6 mm/10.1 mm. The overall symptomatic reherniation and reoperation rate was 2%. During the 1-year follow-up period, mean back pain decreased from 43 to 8 (P < 0.001), leg pain decreased from 71 to 4 (P < 0.001), and the Oswestry Disability Index decreased from 46 to 5 (P < 0.001). Among 15 patients with preoperative neurological deficits, improvements in neurological function were noted in 14 (93%). There were no serious device-related complications. The presented study shows promising early results in using the anular closure device. The procedure is safe with significantly fewer reherniations than for patients with large anular defects without anular closure. Further studies with longer follow-up periods are warranted to prove these findings for long-term outcomes.
Identifiants
pubmed: 31243920
doi: 10.1111/os.12495
pmc: PMC6595107
doi:
Types de publication
Controlled Clinical Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
431-437Informations de copyright
© 2019 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.
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