ABSTRACT
Objective: This study aimed to compare the clinical results of posterior stabilization and
Fusion (DSTFO) and discectomy together with discectomy and to compare the prospective
effects of posterior dynamic system (DDS) surgery in patients with recurrent herniated
discectomy and to present the most appropriate operation.
Material and Method: This study is a randomized prospective study. Fifty patients who
developed recurrent disc for the first time were statistically compared. While the patients were
evaluated, the Japanese Orthopedic Association's evaluation system for low back pain
syndrome (JOA score) was used. Also, the patients were divided into three groups and the
recovery rates, duration of hospitalization, amount of bleeding, follow-up periods and lower
back pain scores were compared.
Results: The average rate of recovery in all patients is 79.19 (±7,700). There was no
significant difference between groups regarding postoperative total JOA score and recovery
rate. However, postoperative back pain is higher in the OD than in the other two groups. A
patient in group OD had a recurrence disk development 18 months after the operation and was
reoperated again. In group OD, dural injury in three cases, infection in one case, and deep
vein thrombosis in one case developed. In the group DSTFO, dural injury in one case and
infection in one case developed. In the group DDS, dural injury in one case and neurological
deficits in one case has generated. When the groups were evaluated regarding intraoperative
blood loss, a statistically significant difference was found between the groups DSTFO
(451,76±45,171) and DDS (447,65±47,635), to group OD (178,75±40,804). When evaluated
concerning the duration of hospitalization, a statistically significant difference was found
between the groups DSTFO (3,82±0,809) and DDS (3,00±0,707), compared to group OD
(1,75±0,856).
Conclusion: Revision surgery is effective in patients with recurrent disc herniation. Revision
surgery with fusion and dynamic system reduces postoperative back pain. Only the
discectomy minimizes the amount of bleeding and hospitalization.