J Korean Soc Spine Surg.  2015 Dec;22(4):140-145. 10.4184/jkss.2015.22.4.140.

Clinical Outcome of Simple Discectomy for Recurrent Lumbar Disc Herniation

• Kim DJ
• Koh YD
• Kim JO
• Lim HM

• KMID: 2150540
• DOI: http://doi.org/10.4184/jkss.2015.22.4.140

Abstract

STUDY DESIGN: This is a retrospective study.
OBJECTIVES
To analyze the clinical outcomes of simple discectomy in patients with recurrent lumbar disc herniation. SUMMARY OF LITERATURE REVIEW: There are two methods of studying the treatment of recurrent lumbar disc herniation. The first type of study considers fusion for the prevention of complications such as postoperative lumbar segmental instability and persistent back pain. The second type of study assumes that simple discectomy without fusion is sufficient in the surgical management of recurrent lumbar disc herniation.
MATERIALS AND METHODS
Sixteen patients who underwent simple discectomy due to recurrent lumbar disc herniation were followed up over 3 years. The mean age was 52.8 years (38-68 years). The mean follow-up period was 75.4 months (36-144 months). VAS scores for back pain and radiating lower leg pain were each compared pre- and post-operatively. The Oswestry Disability Index (ODI) was used to analyze the clinical outcome. A modified MacNab's outcome was used to evaluate patient satisfaction. Subjective survey data in a Delphi checklist was reviewed to verify clinical lumbar instability.
RESULTS
The mean back pain VAS score showed 87.5% improvement (p<0.001). The mean lower leg VAS score showed 89% improvement (p<0.001). The mean preoperative ODI score was 29.9, and the mean score checked at the last follow up was 3.5. It thus showed 88.3% improvement (p<0.001). Excellent or good satisfaction was reported by fourteen patients (87.5%), and clinical lumbar instability was identified in one patient (6.3%).
CONCLUSIONS
Simple discectomy without fusion is one of treatment option for recurrent disc herniation without instability.

Keyword

Lumbar; Recurrence; Disc herniation; Discectomy

MeSH Terms

Back Pain
Checklist
Diskectomy*
Follow-Up Studies
Humans
Leg
Patient Satisfaction
Recurrence
Retrospective Studies

Figure

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  Fig. 1. (A) Left L4-5 disc herniation, (B) After laminectomy and discectomy, (C) Recurrence at 14 months postoperatively.

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