Korean J Spine.  2012 Sep;9(3):170-175. 10.14245/kjs.2012.9.3.170.

Surgical Results and Risk Factors for Recurrence of Lumbar Disc Herniation

Affiliations
  • 1Department of Neurosurgery, Eulji University College of Medicine, Daejeon, Korea. KS3432@eulji.ac.kr

Abstract


OBJECTIVE
Recurrent lumbar disc herniation has been defined as disc herniation at the same level, regardless of ipsilateral or contralateral herniation, with a pain-free interval greater than 6 months. The aim of this study is to analyze outcomes and identify the potential risk factors for recurrent lumbar disc herniation.
METHODS
The authors retrospectively reviewed the cases of 178 patients who underwent open discectomy for single-level lumbar disc herniation. Visual analogue scales and modified Macnab criteria were used to compare the clinical outcomes between the recurrent group and the non-recurrent group. Sex, age, discectomy level, degree of disc degeneration, type of disc herniation, pain-free interval after first-operation, smoking status, and trauma were investigated as potential recurrence risk factors.
RESULTS
Of the 178 patients for whom the authors were able to definitely assess symptomatic recurrence status, 18 patients (10.1%) underwent revision surgery for recurrent disc herniation. The most common level involved was L4-L5 (61%) and the mean period of time to recurrence was 18.7 months (6-61 months). There were 17 cases of ipsilateral herniation and 1 case of contralateral herniation. The types of herniation for which revision surgery was done were protrusion (3 cases), and transligamentous extrusion (14 cases). There were five excellent, eight good, and two fair results.
CONCLUSION
Repeated discectomy for recurrent disc herniation produced unsatisfactory outcomes. Factors such as sex, type of disc herniation and traumatic events were found to be significant risk factors.

Keyword

Lumbar vertebrae; Discectomy; Recurrence; Risk factors

MeSH Terms

Diskectomy
Humans
Intervertebral Disc Degeneration
Lumbar Vertebrae
Oxalates
Recurrence
Retrospective Studies
Risk Factors
Smoke
Smoking
Weights and Measures
Oxalates
Smoke
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