Dose preservation of ligament flavum really help prevent postoperative epidural fibrosis and improve outcome in microdiscectomy?. (October 2020)

• Record Type: Journal Article
• Authors: Li, Jigang; Ma, Qiuhong; Wu, Jiancheng; Zhao, Peiqing; Li, Tao; Li, Jianmin
• Is Part Of: Journal of clinical neuroscience. Volume 80(2020)
• Page Start: 331
• Page End: 335
• Publication Date: 2020-10
• Subjects: Lumbar disc herniation -- Microdiscectomy -- Ligament flavum -- Epidural fibrosis -- Clinical outcome; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2020.06.013
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Present a technique for preserving the ligament flavum during microdiscectomy. Preservation of more ligament flavum is practicable during microdiscectomy. Preservation of more ligament flavum prevent postoperative epidural fibrosis. Preservation of more ligament flavum is helpful to achieve a better clinical outcome. Abstract: Objective: A prospective, randomized, controlled clinical study was conducted with surgery performed by the same surgeon. The aim was to present a new technique for preserving the ligament flavum during lumbar microdiscectomy, and to evaluate whether this helps prevent postoperative fibrosis and improve outcome. Methods: From January to December 2017, 251 patients with indication for microdiscectomy were randomly divided into test group using ligament flavum preservation technique and control group using conventional procedures. Visual analogue scale (VAS) scores and Oswestry Disability Index (ODI) were assessed before the surgery, and 3 days, 1 month, 6 months, 1 year and 2 years after the operation respectively. The grade of epidural fibrosis on MRI after 6 months was evaluated by two radiologists independently and double-blindly. Results: Both groups' VAS and ODI were significantly improved after surgery, but there was no significant difference between two groups at 3d and 1 month after operation. The grade of epidural fibrosis in test group was significantly lower than that in control group at 6 months postoperative. The VAS and ODI were significantly lower in test group than that in control group at 6 months, 1 year and 2 years after operation. Conclusion: Preservation of more ligament flavum is practicable during the procedure of microdiscectomy. It can prevent postoperative epidural fibrosis, and is helpful to achieve a better clinical outcome.