Answer to the Letter to the Editor of Dr. Yusuf Izci entitled 'anular closure device: Is it necessary after discectomy?' concerning 'the high-risk discectomy patient: Prevention of reherniation in patients with large anular defects using an anular closure device' by G. J. Bouma, M. Barth, D. Ledic, M. Vilendecic (2013) Eur Spine J; 22(5):1030-1036

摘要

We appreciate the thoughtful comments by Dr. Izci. Our conclusion that an anular closure device (ACD) may prevent reherniation after limited discectomy was based on our finding of an overall symptomatic reherniation rate of 1.4 % in our patients, which compares favorably to previous studies reporting much higher rates, especially with large anular defects. The relationship between the size of the anular defect and the risk of recurrence has been well documented previously [1]. In addition, the benefits and risks of limited vs. radical discectomy have been investigated in several clinical trials showing less back pain but higher reherniation risk with limited disc removal [2]. It was our assumption that the use of an ACD may overcome the disadvantage of limited discectomy without losing the benefits.