Effects of revision lumbar microdiscectomy and scarectomy versus scarectomy micro-surgery alone in pain perception: a retrospective pilot study.

Abstract

Aim: The aim of this study was to assess if patients undergoing redo microdiscectomy surgery, having scarectomy alone, reported having similar levels of pain relief to patients having surgery for recurrent disc. Scar tissue development is inevitable following lumbar surgery. Scar tissue can have a negative impact on patient's reported quality of life, however most surgeons are reluctant to operate primarily to remove this tissue for fear of a CSF leak and reported poor clinical outcomes. However, studies to date have reported only on outcomes following open surgery. Outcomes for microsurgical removal of scar tissue have not been reported.

Methods: We carried out a retrospective cohort study. We reviewed pre-op letters, operative notes and follow-up clinic letters for patients who underwent revision lumbar discectomy for radiculopathy between 2018 and 2022 at a single institution in Dublin. All patients had their pre and post operative level of pain recorded in clinic letters, using the visual analogue score (VAS).

Results: Our data suggests that complete resection of scar tissue alone seems to have similar improved VAS scores when compared to those having a revision microdiscectomy. Over 92% of patients in our study had an improvement in pain when undergoing removal of scar tissue.

Conclusion: Our small cohort study suggests there is improved post-operative pain scores for those patients who underwent scarectomy for recurrence of radiculopathy.