Tubular Microdiscectomy for Recurrent Disc Prolapse Following Two Rounds of Open Laminectomy and Discectomy: A Case Report and Literature Review

Recurrence of lumbar disc herniation has been reported in 5 e 11% of patients after conventional discectomy, and most of these patients are usually treated with repeated discectomy through the same initial approach. Tubular micro-discectomy is an increasingly popular surgery for lumbar disc prolapse and has replaced conventional open surgery in the last decade. However, it requires more experience and has a steep learning curve, especially in revision cases. We present the fi ndings of a tubular lumbar microdiscectomy performed after two conventional open laminectomies and discectomies, explaining the challenges and dif fi culties in such cases and leading the way for the use of minimally invasive spine surgeries after multiple open surgeries. A case report and literature review was performed. A middle-aged man who had undergone two open laminectomies and discectomies several years ago at L5 e S1 and fenestrated laminectomy at L4 e L5 presented with new radiculopathy over the S1 nerve root dermatome to which a new tubular microdiscectomy was performed. The patient ran a smooth postoperative course, and his symptoms improved. Tubular microdiscectomy achieves the goal of fi xation, is cost-effective, and goes with the patient preference. A successful tubular microdiscectomy is tough to accomplish after two spinal surgeries around and near the same involved spinal nerve.