LUMBAR DISCECTOMY WITH EPIDURAL FAT GRAFT AND ITS EFFECT ON CLINICAL OUTCOME AND SCAR FORMATION: A CASE CONTROL STUDY ON 104 PATIENTS
Journal Title: Journal of Turkish Spinal Surgery - Year 2013, Vol 24, Issue 4
Abstract
Background: Postoperative scar formation appears regularly after lumbar disc surgery, and is seen to be one possible reason for prolonged complaints after surgery. Therefore, several materials have been developed to decrease scarring in the spinal canal, although no significant clinical effects have been proven. Materials and Methods: This retrospective analysis is designed as a case-control study examining the clinical outcome, measured with the Oswestry Disability Score, of 54 patients who received microdiscectomy with an epidural fat graft, compared with 52 patients who received microdiscectomy alone, with a minimum follow-up of one year. For radiological evaluation, the preoperative and one year postoperative MRIs were assessed by a radiologist who was blind to which treatment group the patient belonged. Results: Whereas the requirement for postoperative analgesia was significantly lower in the fat graft group, the analysis showed no significant differences between the groups with regard to clinical outcome or scar formation by MRI one year after surgery. The fat graft was detectable in 65.8% patients on an MRI one year postoperatively. Conclusion: This study confirms the already-known results that fat grafts, as well as other synthetic materials, do not significantly affect the clinical outcome after lumbar disc surgery, even though there is a tendency to detect reduced scar formation on MRI images one year after surgery.
Authors and Affiliations
Albrecht WASCHKE, Ersin HACİYAKUPOGLU, Akin GOKCEDAG, Jan WALTER, Martina KLINNER, Sebastian FINDEKLEE, Pedro DÜNISCH, Rupert REICHART, Christian EWALD, Rolf KALFF
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