Comparison of unilateral posterior lumbar interbody fusion and bilateral posterior interbody fusion with simple discectomy at degenerative disc herniations

To evaluate the early results of unilateral posterior lumbar interbody fusion technique in lumbar discectomy cases compared with simple discectomy and bilateral posterior interbody fusion cases using visual analog scale [VAS] and Oswestry outcomes instruments and radiological and physical examinations. The control group had 40 patients who underwent simple discectomy. In group one, 8 patients had recurrent disc herniations and facet joint hypertrophy, 21 patients had degenerative disc disease and facet joint hypertrophy. In this group polyetheretherketone [PEEK] cage was used for protecting the disc height and recurrence. In group 2, 15 patients had degenerative lumbar disc herniations and bilateral facet joint hypertrophy. All patients were operated upon between October 2002 between February 2004 at the Neurosurgery Department of Kocatepe University Medical School, and were followed by the help of radiological exams, VAS and Oswestry scores, and clinical exams. The groups were compared to each other statistically. In the control group [n=40] there were recurrences and disc height loss. In group one [n=29] there were no recurrences and the height lost was limited. In group 2, [n=15] there was no recurrence, however, the lost disc height was more than group one. If the patient has degenerative disc disease, the use of unilateral posterior PEEK cage and interbody grafting is a safer mode of treatment after discectomy

age a prognostic factor of postoperative outcome of lumbar disc herniation operations?

To evaluate the influence of the patients age on preoperative symptoms and outcome. The general data, symptoms, signs, and neurological examination findings were recorded from 511 patients between 2000 and 2006 at Vakif Gureba Hospital and Afyon Kocatepe University Neurosurgery Departments, Afyonkarahisar, Turkey. The mean follow-up of the patients was 44.7 months. All patients younger than 64 were defined as younger patients [n=449]. The others were defined as elderly patients [n=62]. The measuring method of the outcome was visual analogue rating scale [VAS]. Preoperative and postoperative VAS values were found similar in both the younger and older group. Only preoperative differences were found in the older group, due to systemic disease. The outcome was not statistically different in both groups, indicating that age is not a valuable prognostic factor for lumbar discectomy

Spontaneous regression of lumbar disc herniation

We present 3 cases of spontaneous regression of lumbar herniated disc. The disc regression correlated with clinical improvement documented by MRI studies. Although the phenomenon of spontaneous disappearance of decrease in size of herniated disc fragments is well known, the exact mechanism underlying this process remains unclear. We discuss 3 possible explanations for disc regression: retraction into the vertebral space, dehydration/shrinkage, and resorption due to inflammatory reaction

Neurosurgical gossypiboma radiologically mimicking a lumbar abscess

Lumbar discectomy is the most common operative technique at neurosurgery clinics around the world. The complications of lumbar disc operation include infections, dural tear, bleeding, vascular, and intestinal injuries. Infectious complications of lumbar disc surgery are superficial and profound tissue infections, meningitides, and epidural abscess. Although retained surgical sponges [gossypiboma] are well known intraoperative complications in other surgical branches, they have not been widely reported in neurosurgery. In this report, we present a case of retained surgical sponge at the operation site and discuss with the literature