Epidural scarring after lumbar disc surgery: Equivalent scarring with/without free autologous fat grafts

Surg Neurol Int. 2017 Aug 1:8:169. doi: 10.4103/sni.sni_142_17. eCollection 2017.

Abstract

Background: To limit epidural fibrosis and prevent scar formation/nerve tethering that may contribute to chronic postoperative pain; some surgeons have utilized epidural autologous fat grafts following lumbar microdiscectomy.

Methods: We investigated the correlation between post-microdiscectomy epidural scarring [including select magnetic resonance imaging (MRI) studies] and clinical outcomes in 36 patients operated for symptomatic. MRI documented L4-L5 and L5-S1 disk herniations with (18 patients) and without (18 patient) the application of free fat grafts. In addition, histological evaluation of the original fat grafts was performed in 4 patients requiring additional surgery.

Results: We found no clear association between the use of autologous graft fats and the clinical outcomes in this study.

Conclusion: In this preliminary study involving only 36 patients, the prospective randomized use of free autologous fat grafts did not appear to influence outcomes following microdiscectomy.

Keywords: Epidural fibrosis; failed back syndrome; microdiscectomy; post-discectomy syndrome.