• Peter D Klassen, Geoffrey Lesage, Larry E Miller, Robert Hes, Wolfs Jasper F C JFC Department of Neurosurgery, Haaglanden Medical Center Westeinde Antoniushove, Leidschendam, The Netherlands., Sandro Eustacchio, and Peter Vajkoczy.
• Department of Neurosurgery, Bonifatius Hospital, Lingen, Germany. Electronic address: PeterDouglas.Klassen@hospital-lingen.de.
• World Neurosurg. 2019 Oct 1; 130: e926-e932.

ObjectiveTo determine whether presence of a bone-anchored annular closure device (ACD) impacts reoperation strategies and subsequent outcomes.MethodsPatients with large annular defects after single-level limited lumbar discectomy were randomly allocated to receive an ACD or discectomy alone (controls) and were followed for at least 3 years.ResultsAmong 550 patients, reoperation risk was lower with ACD (11.0% vs. 19.3%). The types of reoperations and operative time were similar in each group, and the ACD did not interfere with surgical planning or operative technique. Fusion success was 87% with ACD versus 85% for controls. Perioperative complications occurred in 22% and 19% of reoperations, respectively. Leg pain and back function were improved with ACD versus controls after fusion procedures, and no group differences were observed after non-fusion reoperations.ConclusionsIn patients undergoing post-discectomy reoperation, patients with an ACD were treated with similar operative techniques, were not exposed to additional surgical risks, and reported comparable clinical outcomes versus those without an ACD.Copyright © 2019. Published by Elsevier Inc.

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