Onyia Chiazor U, Menon Sajesh K
a Neurosurgery Division, Department of Surgery , Obafemi Awolowo University Teaching Hospitals Complex , Ile-Ife , Nigeria.
b Department of Neurosurgery , Amrita Institute of Medical Sciences, Amrita University , Kochi , Kerala , India.
Br J Neurosurg. 2017 Dec;31(6):701-708. doi: 10.1080/02688697.2017.1368451. Epub 2017 Aug 22.
Though different techniques have been successfully employed in the treatment of recurrent lumbar disc herniation, the one which should be considered most ideal has remained a controversy, particularly since there are currently no generally accepted guidelines for surgical care.
To review previous publications comparing the available operative options, with the aim of determining if any of the available interventions gives better outcomes compared to others.
A systematic literature review of previous publications comparing various techniques employed in the surgical treatment of recurrent disc herniation.
All publications investigated in this review clearly demonstrated quite comparable outcomes, with no superiority of one method over the other.
In view of the currently available data and evidence, minimally invasive techniques for revision of recurrent disc herniation do not really appear to be superior to the conventional open surgical approaches and vice-versa. We suggest the management strategy for surgical treatment of each case of recurrence to be simply based on the experience of the surgeon, the available facilities and equipment. Fusion should not be undertaken in all recurrences but should only be considered as an option for revision when spinal instability, spinal deformity or associated radiculopathy is present.
尽管不同技术已成功应用于复发性腰椎间盘突出症的治疗，但哪种技术应被视为最理想的技术仍存在争议，特别是因为目前尚无普遍接受的手术治疗指南。
回顾以往比较现有手术选择的出版物，以确定与其他干预措施相比，是否有任何现有干预措施能带来更好的结果。
对以往比较复发性椎间盘突出症手术治疗中使用的各种技术的出版物进行系统的文献综述。
本综述中调查的所有出版物均清楚显示结果相当，没有一种方法优于另一种方法。
鉴于目前可得的数据和证据，复发性椎间盘突出症翻修的微创技术似乎并不真的优于传统开放手术方法，反之亦然。我们建议，每例复发病例的手术治疗管理策略应仅基于外科医生的经验、可用的设施和设备。并非所有复发病例都应进行融合，只有在存在脊柱不稳、脊柱畸形或相关神经根病时，才应将融合视为翻修的一种选择。
