Surgical Procedure Summary

Objective

To perform a repeat discectomy procedure on a patient with a recurrent disc herniation who is a high-level athlete.

Background

• The patient had previously undergone a discectomy and achieved good results for a time.
• Symptoms reappeared, indicating a recurrent disc herniation.
• The patient is an elite athlete engaged in activities such as boxing.

Procedure Details

• Visualization: Contrast-enhanced images confirmed the recurrent disc herniation.
• Challenges: The revision surgery required careful handling due to the absence of protective ligaments and potential scar tissue adhesion.
• Instrumentation: A custom articulating curette, called "Paprika," was used for precision in dissection.
• Technique:
  • Used blue dye for better visualization.
  • Pimple popping maneuver employed to mobilize and remove disc material without further injury.
  • Maintained integrity of the dural tube.

Instruments and Tools

• Articulating curette (Paprika)
• Drill
• Laser
• Regular pituitary forceps

Outcome

• Successfully removed the loose disc pieces.
• Ensured the dural tube was intact and mobilized.
• Utilized existing incision.
• Positive surgical outcome with expectations for a great recovery.

Personal Reflections

• Every tool has its advantage; the importance of choosing the right tool for the situation.
• Emphasis on spine surgery complexity and variability.
• The procedure felt like a "mission to Mars," emphasizing readiness for any situation.

Conclusion

The surgery concluded successfully with all objectives met. The patient has a positive prognosis, with careful attention to ensure a smooth recovery and return to high-level athletic activity. The surgical team is optimistic about the outcome, having navigated the procedure with precision and care.