Muhammad Abdur Rehman, Saddam Pervaiz, Inamullah Asghar, Muhammad Jahanzaib, Muhammad Akmal Hussain.
Comparison of the Efficacy of Fusion with Non-Fusion Treatment for Recurrent Lumber Disc Herniation (RLDH).
Pak J Neuro Surg Jan ;26(4):698-707.

Objective:  The study compared the efficacy of fusion with non-fusion treatment for recurrent lumbar disc herniation. Materials & Methods:  60 patients including 30 – 65 years of either gender, with recurrent disc herniation and radicular pain from at least six months after primary lumbar disc surgery. Epidural scar tissues were separated and partly resected in patients with RLDH (recurrent lumber disc herniation) undergoing standard revision discectomy (Group A). Posterolateral fusion and trans-pedicular screw fixation were used in Group B. Following the implantation of a subcutaneous suction drain, the closure was performed as usual. The effectiveness was evaluated. The Japanese Orthopedic Association's core was used to measure clinical complaints before and after surgery. Results:  Most of the patients (58.33%) were 46 – 65 years old. The mean recurrent time to primary surgery was 11.87 months. 60% of patients reported ? 12 months recurrent time in group B, and 66.6% in group A. Right side was noted in 26.67% of patients of both groups. The mean pre and post-operative JOA scores were 22.34 and 8.54, respectively. The mean recovery rate was 59.32%. This study reported the efficacy of non-fusion treatment versus fusion treatment as 16.67% and 63.33%, respectively. Conclusion:  We concluded that the fusion treatment is better than the non-fusion treatment for recurrent lumbar disc herniation.

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