J Korean Neurosurg Soc.  2019 Sep;62(5):586-593. 10.3340/jkns.2019.0085.

Risk Factors of Secondary Lumbar Discectomy of a Herniated Lumbar Disc after Lumbar Discectomy

Affiliations
  • 1Department of Neurosurgery, Hanyang University Medical Center, Seoul, Korea. tdy815@hanayang.ac.kr
  • 2Department of Neurological Surgery, University of California, Davis, CA, USA.

Abstract


OBJECTIVE
To study risk factors of secondary lumbar discectomy (LD) for recurrent herniated lumbar disc (HLD) and identify methods to lower the rate of recurrence.
METHODS
Data from 160 patients who underwent primary LD were collected retrospectively. Demographic features, radiologic findings including Pfirrmann disc degeneration, and surgical information were analyzed to compare risks between revision and non-revision patients.
RESULTS
The revision rate was 15% (24 patients), and the mean follow-up was 28.3 months. HLD recurrence was not related to any demographic characteristics. Primary and secondary LD were most common at the L4-5 level, but the level of operation was not significantly associated with revision. Primary LD most commonly had a Pfirrmann disc degeneration grade of 3, followed by 4. For recurrent HLD, Pfirrmann grade 4 was most common and was statistically significant (p<0.05). A body mass index (BMI) over 30 was considered obese and was significantly related with HLD revision (p<0.05).
CONCLUSION
Patients with high BMI or severe disc degeneration should be informed of HLD revision.

Keyword

Body mass index; Diskectomy; Recurrence; Reoperation

MeSH Terms

Body Mass Index
Diskectomy*
Follow-Up Studies
Humans
Intervertebral Disc Degeneration
Recurrence
Reoperation
Retrospective Studies
Risk Factors*
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