Summary
Background. Postoperative epidural fibrosis is a major causative factor of low-back pain even if microsurgical techniques are adopted to reduce this phenomenon. To prevent the recurrent radicular pain caused by this problem, we utilized adipose tissue drawn from the same patient; at the end of surgical procedure, the fat was placed around the spinal root or the dural sac. This procedure was evaluated by a prospective, randomised study.
Method. From 180 patients operated on for lumbar discectomy between January 2000 to December 2001, 74 were enclosed in the study. In 37 patients, the spinal root was covered by autologous fat (group A), in the other 37 (control group, B), this procedure was not adopted. One year after surgery, all the patients were evaluated with clinical and radiological (Magnetic Resonance Imaging) follow-up. Only two patients were lost to follow-up.
Findings. 71% of the patients in group A had 100% of clinical and radiological post-operative outcome score; this result was obtained only in 35% of the patients in group B. A clinical score evaluating pain syndrome (from grade 0 to 5) and a radiological score evaluating postoperative fibrosis (from grade 0 to 4) was adopted. Therefore, group A had best outcome as compared to control group.
Conclusions. The authors found a positive effect in the recon- struction of epidural fat with autograft of adipose tissue to prevent postoperative scarring and failed-back syndrome related to postoperative fibrosis.
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References
Beaujeux R, Wolfram-Gabel R, Kehrli P, Fabre M, Dietemann JL, Maitrot D, Bourjat P (1997) Posterior lumbar epidural fat as a functional structure? Histologic specificities. Spine 22: 1264–1268
Cobanoglu S, Imer M, Ozylmaz F, Memis M (1995) Complication of epidural fat graft in lumbar spine disc surgery: case report. Surg Neurol 44: 479–481
Gorgulu A, Simsek O, Cobanoglu S, Imer M, Parsak T (2003) The effect of epidural free fat graft on the outcome of lumbar disc surgery. Neurosurg Rev Oct 8: (published online)
Kanamori M, Kawaguchi Y, Ohmori K, Kimura T, Md HT, Matsui H (2001) The fate of autogenous free-fat grafts after posterior lumbar surgery: part 1. A postoperative serial magnetic resonance imaging study. Spine 26: 2258–2263
Kanamori M, Kawaguchi Y, Ohmori K, Kimura T, Tsuji H, Matsui H (2001) The fate of autogenous free-fat grafts after posterior lumbar surgery: part 2. Magnetic resonance imaging and histologic studies in repeated surgery cases. Spine 26: 2264–2270
Martin-Ferrer S (1989) Failure of autologous fat grafts to prevent postoperative epidural fibrosis in surgery of the lumbar spine. Neurosurgery 24: 718–721
Wolfram-Gabel R, Beaujeux R, Fabre M, Kehrli P, Dietemann JL, Bourjat P (1996) Histologic characteristics of posterior lumbar epidural fatty tissue. J Neuroradiol 23: 19–25
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© 2005 Springer-Verlag
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Gambardella, G., Gervasio, O., Zaccone, C., Puglisi, E. (2005). Prevention of recurrent radicular pain after lumbar disc surgery: a prospective study. In: Alexandre, A., Bricolo, A., Millesi, H. (eds) Advanced Peripheral Nerve Surgery and Minimal Invasive Spinal Surgery. Acta Neurochirurgica, vol 97. Springer, Vienna. https://doi.org/10.1007/3-211-27458-8_33
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DOI: https://doi.org/10.1007/3-211-27458-8_33
Publisher Name: Springer, Vienna
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