Packing of intervertebral spaces with oxidized regenerated cellulose to prevent the recurrence of lumbar disc herniation.

Objective: To investigate the impact of packing of intervertebral spaces with oxidized regenerated cellulose (ORC) on the incidence of recurrence of lumbar disc herniation (LDH).

Methods: We retrospectively reviewed 158 consecutive patients who underwent surgery for a newly diagnosed LDH and had a minimum of 18 months of follow-up. Single-level (151 patients) and two-level (7 patients) procedures accounted for 165 microdiscectomies. After microsurgical removal of disc herniation and curettage, the interspaces were tightly packed with ORC.

Results: The average hospital stay was 1.47 days, without any relevant and permanent complications. In particular, complications related to intervertebral ORC packing were never observed. At a median follow-up of 29 months (range, 18-51 mo), the pain decreased or disappeared in almost all patients and the patient satisfaction rate was very high. A recurrence of LDH was observed in two patients (1.34%), both of whom needed a second operation. Three patients (2.01%) experienced a disc herniation involving another intervertebral space.

Conclusion: Our preliminary results suggest that the packing of intervertebral spaces with ORC at the end of microdiscectomy is a safe technique that may reduce the incidence of recurrent LDHs, although the true impact of this technique on long-term follow-up is still unclear. At the moment, it seems reasonable to assume that this technique should be used only under the auspices of large clinical investigations with prospective and randomized protocols.