The Brussels International Spine Symposium (BISS) is globally recognized as one of the world leading, state-of-art annual meetings in Spine. Under the auspice of Drs. Marek Szpalski and Robert Gunzburg, the 25th anniversary meeting took place on 16-17 November 2018 reviewing the topic of Disc Herniation – Back to Basics: Controversies in diagnosis, management and costs.
One of the recurring messages that echoed from the podium, was the need for alternative treatment strategies, that help bringing down the high reoperation rates as seen in the lumbar discectomy population. Prof. Richard Assaker (Lille, France) presented a study (Martens et al, JBJS 2018) that clearly showed the risk factors contributing to these reoperations. He reported a 25% herniation recurrence rate in patients that have large defects in the annulus. This patient group is therefore at much higher risk for repeat surgery.
A novel treatment option to consider for these patients is to close large annular defects with the Barricaid implant. Dr. Mark Arts (The Hague, Netherlands) presented the 3-year superiority results from a level 1, multicenter RCT. Their study demonstrated a 50% reduction in reoperations when using Barricaid, as compared to treating these patients with today’s gold standard, that is microdiscectomy alone.
Furthermore, Dr. Scott Blumenthal (Texas Back Institute, Plano TX) referenced the Barricaid health economic analysis (Ament et al, Spine 2018) that has proven Barricaid to be both cost-effective, as well as offering patients superior quality of life at less cost, when used for these high-risk patients.