Anterior lumbar discectomy and fusion for acute cauda equina syndrome caused by recurrent disc prolapse: report of 3 cases.

2.50
Hdl Handle:
http://hdl.handle.net/11287/620447
Title:
Anterior lumbar discectomy and fusion for acute cauda equina syndrome caused by recurrent disc prolapse: report of 3 cases.
Authors:
Tan, Kimberly-Anne; Sewell, Mathew David; Markmann, Yma; Clarke, Andrew J; Stokes, Oliver M.; Chan, Daniel
Abstract:
There is a lack of information and consensus regarding the optimal treatment for recurrent disc herniation previously treated by posterior discectomy, and no reports have described an anterior approach for recurrent disc herniation causing cauda equina syndrome (CES). Revision posterior decompression, irrespective of the presence of CES, has been reported to be associated with significantly higher rates of dural tears, hematomas, and iatrogenic nerve root damage. The authors describe treatment and outcomes in 3 consecutive cases of patients who underwent anterior lumbar discectomy and fusion (ALDF) for CES caused by recurrent disc herniations that had been previously treated with posterior discectomy. All 3 patients were operated on within 12 hours of presentation and were treated with an anterior retroperitoneal lumbar approach. Follow-up ranged from 12 to 24 months. Complete retrieval of herniated disc material was achieved without encountering significant epidural scar tissue in all 3 cases. No perioperative infection or neurological injury occurred, and all 3 patients had neurological recovery with restoration of bladder and bowel function and improvement in back and leg pain. ALDF is one option to treat CES caused by recurrent lumbar disc prolapse previously treated with posterior discectomy. The main advantage is that it avoids dissection around epidural scar tissue, but the procedure is associated with other risks and further evaluation of its safety in larger series is required.
Citation:
Anterior lumbar discectomy and fusion for acute cauda equina syndrome caused by recurrent disc prolapse: report of 3 cases. 2017, 27 (4):352-356 J Neurosurg Spine
Publisher:
American Association of Neurological Surgeons
Journal:
Journal of Neurosurgery. Spine
Issue Date:
Oct-2017
URI:
http://hdl.handle.net/11287/620447
DOI:
10.3171/2017.1.SPINE16352
PubMed ID:
28708040
Additional Links:
http://thejns.org/doi/abs/10.3171/2017.1.SPINE16352?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed
Type:
Case Report
Language:
en
ISSN:
1547-5646
Appears in Collections:
Exeter Spinal Surgery Unit; 2017 RD&E publications

Full metadata record

DC FieldValue Language
dc.contributor.authorTan, Kimberly-Anneen
dc.contributor.authorSewell, Mathew Daviden
dc.contributor.authorMarkmann, Ymaen
dc.contributor.authorClarke, Andrew Jen
dc.contributor.authorStokes, Oliver M.en
dc.contributor.authorChan, Danielen
dc.date.accessioned2017-10-13T15:01:45Z-
dc.date.available2017-10-13T15:01:45Z-
dc.date.issued2017-10-
dc.identifier.citationAnterior lumbar discectomy and fusion for acute cauda equina syndrome caused by recurrent disc prolapse: report of 3 cases. 2017, 27 (4):352-356 J Neurosurg Spineen
dc.identifier.issn1547-5646-
dc.identifier.pmid28708040-
dc.identifier.doi10.3171/2017.1.SPINE16352-
dc.identifier.urihttp://hdl.handle.net/11287/620447-
dc.description.abstractThere is a lack of information and consensus regarding the optimal treatment for recurrent disc herniation previously treated by posterior discectomy, and no reports have described an anterior approach for recurrent disc herniation causing cauda equina syndrome (CES). Revision posterior decompression, irrespective of the presence of CES, has been reported to be associated with significantly higher rates of dural tears, hematomas, and iatrogenic nerve root damage. The authors describe treatment and outcomes in 3 consecutive cases of patients who underwent anterior lumbar discectomy and fusion (ALDF) for CES caused by recurrent disc herniations that had been previously treated with posterior discectomy. All 3 patients were operated on within 12 hours of presentation and were treated with an anterior retroperitoneal lumbar approach. Follow-up ranged from 12 to 24 months. Complete retrieval of herniated disc material was achieved without encountering significant epidural scar tissue in all 3 cases. No perioperative infection or neurological injury occurred, and all 3 patients had neurological recovery with restoration of bladder and bowel function and improvement in back and leg pain. ALDF is one option to treat CES caused by recurrent lumbar disc prolapse previously treated with posterior discectomy. The main advantage is that it avoids dissection around epidural scar tissue, but the procedure is associated with other risks and further evaluation of its safety in larger series is required.en
dc.language.isoenen
dc.publisherAmerican Association of Neurological Surgeonsen
dc.relation.urlhttp://thejns.org/doi/abs/10.3171/2017.1.SPINE16352?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmeden
dc.rightsArchived with thanks to Journal of neurosurgery. Spineen
dc.subjectWessex Classification Subject Headings::Orthopaedicsen
dc.subject.meshAdult-
dc.subject.meshDiskectomy-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshIntervertebral Disc Displacement-
dc.subject.meshLumbar Vertebrae-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPolyradiculopathy-
dc.subject.meshProlapse-
dc.subject.meshRecurrence-
dc.subject.meshSpinal Fusion-
dc.titleAnterior lumbar discectomy and fusion for acute cauda equina syndrome caused by recurrent disc prolapse: report of 3 cases.en
dc.typeCase Reporten
dc.identifier.journalJournal of Neurosurgery. Spineen
dc.type.versionPublisheden

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