Diagnosis
Recurrent or persistent lumbar symptoms after previous lumbar surgery, with clinically concordant imaging findings and objective neurologic deficit requiring revision endoscopic lumbar interbody fusion.
Procedure and level
Revision endoscopic lumbar interbody fusion at the clinically concordant level. Clinically concordant lumbar revision level.
Surgical levels and level count
- Treated levels
- Level count not reported
- Decompression
- Level count not reported
- New fusion
- Level count not reported
The source says clinically concordant revision level but does not identify the operated segment(s).
One level means one treated motion segment, such as L4-L5. Decompression and fusion can overlap; their counts are not added. Counts follow the source description and have not been re-audited against private charts.
Clinical presentation
The patient presented with persistent leg-dominant symptoms after previous lumbar surgery. Symptoms continued despite medication, physical therapy, and injection treatment. The case was evaluated for revision surgical treatment because symptoms and neurologic findings persisted.
Neurologic findings
Preoperative neurologic examination demonstrated left L5 dermatome sensory disturbance, left ankle dorsiflexion weakness approximately grade 3, and left great toe dorsiflexion weakness approximately grade 3.
Prior nonoperative treatment
Symptoms persisted despite medication, physical therapy, and injection treatment. Revision surgery was considered because the symptoms remained clinically significant and were associated with objective neurologic deficit.
Imaging and clinical concordance
Preoperative radiographs and MRI demonstrated postoperative lumbar changes from the previous surgery and recurrent or residual pathology at the clinically concordant level. Imaging findings were reviewed together with the patient's symptoms and neurologic examination to determine the revision target and the need for interbody fusion rather than decompression alone.
Reasoning recorded for the procedure
Revision endoscopic lumbar interbody fusion was selected because the patient had persistent or recurrent symptoms after previous lumbar surgery, associated with objective neurologic deficit and imaging-symptom concordance. The operative objective was decompression of the symptomatic neural structures together with stabilization of the pathologic segment when appropriate.
Operative considerations
Revision endoscopic lumbar interbody fusion was performed. The operative workflow focused on safe re-entry into the previous surgical field, careful dissection through scarred tissue, identification of the symptomatic level, neural decompression, disc space preparation, interbody fusion, and stabilization as appropriate. A key technical point in this revision setting was cautious dissection of adhesions related to the previous surgery, with attention to avoiding unnecessary traction or injury to neural and dural structures.
Postoperative course
Not reported in the available educational summary.
Postoperative imaging
Not reported in the available educational summary.
Educational point
This case illustrates that revision endoscopic lumbar interbody fusion after previous lumbar surgery requires careful surgical planning and controlled tissue handling. In the revision setting, adhesions from the prior operation may obscure normal tissue planes. Careful dissection of scarred and adherent tissue is essential to maintain a safe working corridor and to reduce the risk of neural or dural injury.
Published images and video
Media are identified by their public source. Journal figures open at the original source; operative video illustrates a technical example. Imaging and operative appearances do not measure pain relief, function, or durable fusion.
Clinical history
preoperative imaging
postoperative imaging
Reported observations and missing data
Values below are limited to what the identified public source reports; source charts were not re-audited for this website update. Operative-time definitions and observation windows may differ. Do not compare these values across surgeons or procedures.
- Operative time
- 90 minutes.
- Estimated blood loss
- Approximately 450 mL.
- Hospital stay
- 7 days.
- Complications
- Not reported in the available educational summary.
- Follow-up interval
- Not reported in the available educational summary.
- Validated patient-reported outcome scores
- Not reported in the available educational summary.
Evidence and further reading
These sources provide clinical context. They are separate from the source records for this case and do not verify its outcome.
Coauthored publication · technical report
Biportal Endoscopic Spinal Surgery for Recurrent Lumbar Disc HerniationsChoi DJ, Jung JT, Lee SJ, Kim YS, Jang HJ, Yoo B. Clin Orthop Surg. 2016;8(3):325–329.
A published technical discussion of biportal revision discectomy, scar dissection, and preservation of remaining stabilizing structures.
Applicability: This report concerns recurrent disc herniation. It does not establish the benefit of revision fusion or validate outcomes in the cases on this website.
External evidence · randomized trial
Decompression alone or with fusion for degenerative lumbar spondylolisthesis (Nordsten-DS): five year follow-upKgomotso EL et al. BMJ. 2024;386:e079771.
At five years, decompression alone was non-inferior to decompression with instrumented fusion in the trial population.
Applicability: Patient selection and exclusions matter. These findings do not establish that every slip needs fusion, nor compare UBE-TLIF with all alternative techniques.
Source, authorship, and limitations
Source material: Hanjin Jang, MD academic case collection. Case 03 in the previously published Case-Based Education collection by Hanjin Jang, MD. A separate case-level clinical review date and public consent record are not reported in the available source. This entry was organized on 2026-09-11; this date records a website update, not a new clinical review.
Selection is educational. No population denominator, consecutive recruitment process, comparative group, or complete follow-up dataset is supplied. A missing complication field does not mean that no complication occurred. Published observations do not predict another patient's outcome.
No new private patient files were added in this update. Corrections and future clinical additions follow the editorial policy.
Suggested citation: Hanjin Jang, MD academic case collection. Revision Endoscopic Lumbar Interbody Fusion. Casebank, Case 03. Updated 2026-09-11. https://www.hanjinjangspine1.com/casebank/revision-endoscopic-lumbar-fusion