Outcome of Lumbar Trans-Pedicular Fixation in Management of Recurrent Lumber Disc Herniation

Abstract Background: Recurrent lumbar disc herniation is one of the common problems facing most of neurosurgeons and spine surgeons. Treatment options include conservative management (pharmacological and physical therapy) and finally surgical intervention. Surgical options include repeat discectomy and adhesolysis with or without instrumented spinal fusion. Fusion is usually suggested for patients with deformity, instability, or associated axial low back pain. Aim of Study: This study aims to evaluate the role of trans-pedicular fixation in the management of recurrent lumbar disc herniation. Patients and Methods: The study was carried out on 20 patients with recurrent lumber disc herniation underwent surgery for discectomy with trans-pedicular fixation with postero-lateral inter-transverse fusion at neurosurgery depart-ment at Benha university hospital, in the duration between 12/2016 to 12/2018 with minimum follow-up 6 months. All the patients were clinically examined carefully, Preoperatively and post-operatively, low back pain and radiculopathy were assessed by visual analogue score (VAS). Patients were radiologicaly investigated by MRI and dynamic X-rays. Results: All the patients were improved clinically imme-diately after surgery. The Median VAS for back pain and radiculopathy significantly decreased from 8 pre-operatively to 2 post-operatively. Post-operative radiological assessment was done for all 20 patients by CT LSS to asses accuracy of instrumentation and fusion. Conclusion: Using Trans-pedicular fixation and fusion for treatment of recurrent LDP provide adequate Clinical improvement for LBP and sciatica giving chance for better nerve root decompression and avoid mico-instability.