Reherniation

[Gil Denis]

A Big Thank You To All

I am hanging by a silk thread

Just received a Email from Dr D in L.A. would like to see my profile.

Here we go again

Thanks

Gil

[Gil Denis]

Hello

Just a bump, Mark what is your opinion?

Thanks

Gil

[Crystal33]

Gil,
Don't know if u have made enquiry here. Selective Endoscopic Discectomy™
Mark rates them very highly. I like the idea of keyhole and visual approach. Combined with biologic treatment for regenerating nucleus and healing annulus would be the ultimate treatment.

Tony or Chris Yeung... DISC - Desert Instititute for Spine Care, The Leaders in Minimally Invasive Endoscopic Laser Spine Surgery...."advances in endoscopic surgical technique has allowed for successful endoscopic treatment of conditions such as Failed Back Surgery Syndrome caused by recurrent disc herniation, lateral recess stenosis, foraminal osteophytes, facet cysts, and many degenerative conditions of the lumbar spine such as degenerative and isthmic spondylolisthesis. Where the patho-anatomy can be accessed through the foraminal approach, treatment options may be possible. Biologics are also being considered for tissue healing and regeneration."

[Maria]

Gil,
Re Dr.D.- if you have the opportunity to go and see him or have him review your case then I'd go ahead with that. I doubt he'd want to see it/review it if he didn't think there was something he could offer you...

[mmglobal]

Just an interesting coincidence.... Yes I do rate Tony and Chris Yeung and their SED procedure, diagnostic ability, etc... very highly. I have seen many people go to them and I believe that their style of discectomy is highly advantageous in many (but not all) cases. I also rate Dr. Delamarter and his operation very highly. There is no one with more ADR experience in the US.

Few years ago, I was observing a client's surgery with Tony Yeung in Pheonix. Across the table, the assistant surgeon said, "Hey Mark, remember me?"

With scrubs, hat, and a surgical mask, everyone looks about the same. It turned out to be Justin Field. He had been Dr. Delamarter's fellow early in my career as a patient advocate and had helped me with MANY clients. He's a great guy and a top surgeon. He has a very interesting bio. Read it here:

Justin S. Field, M.D.

All the best,

Mark

[Crystal33]

Dr Hoogland is reputed to be one of the world's best at endoscopic spinal surgery. I personally am always a little guarded when review is undertaken by a doctor about his own work, which seems to be common practice.

2008 Apr 20;33(9):973-8.
Endoscopic transforaminal discectomy for recurrent lumbar disc herniation: a prospective, cohort evaluation of 262 consecutive cases.

Hoogland T, van den Brekel-Dijkstra K, Schubert M, Miklitz B.

Department of Spine Surgery, Alpha Klinik Munich, Germany. hoogland@alphaklinik.de
Abstract

STUDY DESIGN: A prospective, cohort evaluation of 262 consecutive patients who underwent transforaminal endoscopic excision for recurrent lumbar disc herniation, after previous discectomy.
OBJECTIVE: To review complications and results of the endoscopic transforaminal discectomy (ETD) for recurrent herniated disc with a 2-year follow-up.
SUMMARY OF BACKGROUND DATA: Recurrent herniation is a significant problem, as scar formation and progressive disc degeneration may lead to increased morbidity after traditional posterior reoperation. The studies published until now on recurrent disc herniation concern various operative techniques, mostly the lumbar microdiscectomy, which is still seen as the standard. The advantage of ETD could be that there is no need to go through the old scar tissue and the procedure can be performed in local anesthesia. The disadvantage may be a long learning curve for the surgeon.
METHOD: Between January 1994 and November 2002, 262 patients with primarily radicular problems underwent an ETD for a recurrent herniated disc. Two hundred and thirty-eight of these patients (90.84%) completed our 2-year follow-up questionnaire. Initial surgery of 82 patients was performed in-house, 180 external. Average age was 46.4 years. The female/male ratio was 29/71%.
RESULTS: At 2-year follow-up 85.71% of patients rated the result of the surgery as excellent or good. 9.66% reported a fair and 4.62% patients an unsatisfactory result. Average improvement of back pain of 5.71 points and 5.85 points of leg pain on the VAS scale (1-10). According to Mac Nab, 30.67% of the patients felt fully regenerated, 50% felt their functional capacity to be slightly restricted, 16.81% felt their functional capacity noticeably restricted, and 2.52% felt unimproved or worse. All patients participated in a 3-month follow-up to establish the perioperative complications. The overall complication rate was 10/262 (3.8%), including 3 nerve root irritations and 7 early recurrent herniations (<3 month). There was no case of infection or discitis. After 3 months and within 2 years, 4 patients have been treated for a recurrent herniated disc in our own center and 7 patients have been treated elsewhere, resulting in a recurrence rate 11/238 (4.62%).

CONCLUSION: ETD for recurrent disc herniation seems to be an effective method with few complications and a high patient satisfaction.

[Keano16]

Interesting thing about endocopic technique is that it has similar results world-wide by 10 different surgeons.