Evaluation of lumbar fusion in recurrent disc prolapse

Abstract

Recurrent lumbar disc prolapse is one of the most common causes of post laminectomy failure syndrome, it is due to recurrence of disc prolapse at the same previously operated level and side documented by MRI of LSS and also failure of medical treatment for at least 6 months. There were many risk factors that may influence recurrence of LDP including age, gender, smoking, heavy work and DM. Recurrent sciatica, positive straight leg raising test, motor and sensory deficit are the most important clinical finding for diagnosis of RLDP. MRI LSS with contrast is the modality of choice in diagnosis and differentiation of RLDP, dynamic plain x ray LSS is essential for confirmation of stability. Surgical treatment (either by open discectomy, discectomy and fixation or Percutaneous interlaminar lumbar discectomy PEILD) are different options for management of RLDP. But the optimal surgical approach for RLDP remains a subject of controversy. Incidental durotomy were mainly occurred near the disc and adjacent to nerve root and need for immediate repair