Open AccessSurgical Experience and Complications in 50 Patients Treated with an Anular Closure Device Following Lumbar Discectomy
Author(s) -
Ardeshiri Ardeshir,
Miller Larry E,
Synowitz Michael,
Jadik Senol
Publication year - 2019
Publication title -
orthopaedic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.666
H-Index - 23
eISSN - 1757-7861
pISSN - 1757-7853
DOI - 10.1111/os.12495
Subject(s) - medicine , discectomy , lumbar , surgery , oswestry disability index , back pain , low back pain , pathology , alternative medicine
Objective To examine the results of an anular closure device for prevention of lumbar disc reherniation in daily routine practice. Methods 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. Results 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. Conclusions 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.