COMPARISON OF SEQUESTRECTOMY AND AGGRESSIVE DISCECTOMIES IN TERMS OF RECURRENCE IN LUMBAR DISC HERNIA SURGERIES

Özet

Objective: Lumbar disc herniation (LDH) is a disease that seriously affects people’s social and work life. LDH recurrence is a condition that occurs after lumbar microdiscectomy and is characterised by findings of failed lumbar surgery syndrome. Recurrent disk herniation may develop due to demographic factors, obesity and limited discectomy. Therefore, this study aimed to compare the recurrent disk herniations that develop following aggressive discectomy (AD) and sequestrectomy. Materials and Methods: Seventy patients diagnosed with extruded LDH at a single level who underwent sequestrectomy (S) and 70 patients with the same diagnosis who underwent AD at Başkent University Zübeyde Hanım Hospital were enrolled in this study. In the study groups, age, gender, comorbidity characteristics, disk herniation level, duration of surgery, blood loss, hospitalisation duration and complications including recurrence rate, reoperation rate, low back pain postoperatively and visual analogue scale for radicular pain during the last evaluation and analgesic application results were collected in addition to the perioperative information. Results: In the comparison S and AD, recurrence (62.50%) and reoperation rates (57.10%) were found to be higher in patients who underwent sequestrectomy. Although surgical site infection (50.00%) occurred at the same proportion in both groups, the rate of dural tear (66.70%) was found to be higher in those who underwent sequestrectomy. Conclusion: Although several noninvasive procedures have been defined as an alternative to microsurgery, surgical discectomy remains an effective treatment method for LDH. We suggest that for cases of LDH recurrence, AD is more preferred over other surgical methods.