Recurrent lumbar disc herniation

Results of operative management

Kyung Soo Suk, Hwan Mo Lee, seonghwan moon, Nam Hyun Kim

Research output: Contribution to journalArticle

185 Citations (Scopus)

Abstract

Study Design. A retrospective evaluation of 28 patients with recurrent lumbar disc herniation. Objectives. To analyze the outcome of the revisions (repeat discectomy), the risk factors of recurrent disc herniation, and the factors that influenced the outcomes of repeat discectomy. Summary of Background Data. Recurrent herniation following disc excision has been reported in 5-11% of patients. There have been many studies on recurrent disc herniation, but these studies have analyzed mixed patient populations. Methods. Recurrent lumbar disc herniation was defined as disc herniation at the same level, regardless of ipsilateral or contralateral herniation, with a pain-free interval greater than 6 months. Eight women and 20 men were studied. The levels of disc herniation were L4-L5 (19 cases) and L5-S1 (9 cases). Gadolinium-enhanced magnetic resonance imaging was performed in all patients. Revision surgery was performed in all patients by using conventional open discectomy. The pain-free interval, side and degree of herniation, operation time, duration of hospital stay, and clinical improvement rate were recorded. Results. The mean pain-free interval was 60.8 months. There were 21 cases of ipsilateral herniation and 7 cases of contralateral herniation. The degrees of herniation in revision were protrusion (14 cases), subligamentous extrusion (3 cases), transligamentous extrusion (8 cases), and sequestration (3 cases). The degrees of herniation in the previous discectomy were protrusion (17 cases), subligamentous extrusion (10 cases), and transligamentous extrusion (1 case). The length of surgery was significantly different (P = 0.003) between the revision surgery and the previous discectomy. There were no significant differences between revision and previous surgery in terms of hospital stay or clinical improvement rates. Age, gender, smoking, professions, traumatic events level and degree of herniation, and pain-free interval did not affect the clinical outcomes. Conclusion. Conventional open discectomy as a revision surgery for recurrent lumbar disc herniation showed satisfactory results that were comparable with those of primary discectomy. Based on the results of this study, repeat discectomy can be recommended for the management of recurrent lumbar disc herniation.

Original languageEnglish
Pages (from-to)672-676
Number of pages5
JournalSpine
Volume26
Issue number6
DOIs
Publication statusPublished - 2001 Mar 15

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Diskectomy
Reoperation
Length of Stay
Gadolinium
Smoking
Magnetic Resonance Imaging
Pain-Free

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Suk, Kyung Soo ; Lee, Hwan Mo ; moon, seonghwan ; Kim, Nam Hyun. / Recurrent lumbar disc herniation : Results of operative management. In: Spine. 2001 ; Vol. 26, No. 6. pp. 672-676.
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abstract = "Study Design. A retrospective evaluation of 28 patients with recurrent lumbar disc herniation. Objectives. To analyze the outcome of the revisions (repeat discectomy), the risk factors of recurrent disc herniation, and the factors that influenced the outcomes of repeat discectomy. Summary of Background Data. Recurrent herniation following disc excision has been reported in 5-11{\%} of patients. There have been many studies on recurrent disc herniation, but these studies have analyzed mixed patient populations. Methods. Recurrent lumbar disc herniation was defined as disc herniation at the same level, regardless of ipsilateral or contralateral herniation, with a pain-free interval greater than 6 months. Eight women and 20 men were studied. The levels of disc herniation were L4-L5 (19 cases) and L5-S1 (9 cases). Gadolinium-enhanced magnetic resonance imaging was performed in all patients. Revision surgery was performed in all patients by using conventional open discectomy. The pain-free interval, side and degree of herniation, operation time, duration of hospital stay, and clinical improvement rate were recorded. Results. The mean pain-free interval was 60.8 months. There were 21 cases of ipsilateral herniation and 7 cases of contralateral herniation. The degrees of herniation in revision were protrusion (14 cases), subligamentous extrusion (3 cases), transligamentous extrusion (8 cases), and sequestration (3 cases). The degrees of herniation in the previous discectomy were protrusion (17 cases), subligamentous extrusion (10 cases), and transligamentous extrusion (1 case). The length of surgery was significantly different (P = 0.003) between the revision surgery and the previous discectomy. There were no significant differences between revision and previous surgery in terms of hospital stay or clinical improvement rates. Age, gender, smoking, professions, traumatic events level and degree of herniation, and pain-free interval did not affect the clinical outcomes. Conclusion. Conventional open discectomy as a revision surgery for recurrent lumbar disc herniation showed satisfactory results that were comparable with those of primary discectomy. Based on the results of this study, repeat discectomy can be recommended for the management of recurrent lumbar disc herniation.",
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Recurrent lumbar disc herniation : Results of operative management. / Suk, Kyung Soo; Lee, Hwan Mo; moon, seonghwan; Kim, Nam Hyun.

In: Spine, Vol. 26, No. 6, 15.03.2001, p. 672-676.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Recurrent lumbar disc herniation

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AU - Suk, Kyung Soo

AU - Lee, Hwan Mo

AU - moon, seonghwan

AU - Kim, Nam Hyun

PY - 2001/3/15

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N2 - Study Design. A retrospective evaluation of 28 patients with recurrent lumbar disc herniation. Objectives. To analyze the outcome of the revisions (repeat discectomy), the risk factors of recurrent disc herniation, and the factors that influenced the outcomes of repeat discectomy. Summary of Background Data. Recurrent herniation following disc excision has been reported in 5-11% of patients. There have been many studies on recurrent disc herniation, but these studies have analyzed mixed patient populations. Methods. Recurrent lumbar disc herniation was defined as disc herniation at the same level, regardless of ipsilateral or contralateral herniation, with a pain-free interval greater than 6 months. Eight women and 20 men were studied. The levels of disc herniation were L4-L5 (19 cases) and L5-S1 (9 cases). Gadolinium-enhanced magnetic resonance imaging was performed in all patients. Revision surgery was performed in all patients by using conventional open discectomy. The pain-free interval, side and degree of herniation, operation time, duration of hospital stay, and clinical improvement rate were recorded. Results. The mean pain-free interval was 60.8 months. There were 21 cases of ipsilateral herniation and 7 cases of contralateral herniation. The degrees of herniation in revision were protrusion (14 cases), subligamentous extrusion (3 cases), transligamentous extrusion (8 cases), and sequestration (3 cases). The degrees of herniation in the previous discectomy were protrusion (17 cases), subligamentous extrusion (10 cases), and transligamentous extrusion (1 case). The length of surgery was significantly different (P = 0.003) between the revision surgery and the previous discectomy. There were no significant differences between revision and previous surgery in terms of hospital stay or clinical improvement rates. Age, gender, smoking, professions, traumatic events level and degree of herniation, and pain-free interval did not affect the clinical outcomes. Conclusion. Conventional open discectomy as a revision surgery for recurrent lumbar disc herniation showed satisfactory results that were comparable with those of primary discectomy. Based on the results of this study, repeat discectomy can be recommended for the management of recurrent lumbar disc herniation.

AB - Study Design. A retrospective evaluation of 28 patients with recurrent lumbar disc herniation. Objectives. To analyze the outcome of the revisions (repeat discectomy), the risk factors of recurrent disc herniation, and the factors that influenced the outcomes of repeat discectomy. Summary of Background Data. Recurrent herniation following disc excision has been reported in 5-11% of patients. There have been many studies on recurrent disc herniation, but these studies have analyzed mixed patient populations. Methods. Recurrent lumbar disc herniation was defined as disc herniation at the same level, regardless of ipsilateral or contralateral herniation, with a pain-free interval greater than 6 months. Eight women and 20 men were studied. The levels of disc herniation were L4-L5 (19 cases) and L5-S1 (9 cases). Gadolinium-enhanced magnetic resonance imaging was performed in all patients. Revision surgery was performed in all patients by using conventional open discectomy. The pain-free interval, side and degree of herniation, operation time, duration of hospital stay, and clinical improvement rate were recorded. Results. The mean pain-free interval was 60.8 months. There were 21 cases of ipsilateral herniation and 7 cases of contralateral herniation. The degrees of herniation in revision were protrusion (14 cases), subligamentous extrusion (3 cases), transligamentous extrusion (8 cases), and sequestration (3 cases). The degrees of herniation in the previous discectomy were protrusion (17 cases), subligamentous extrusion (10 cases), and transligamentous extrusion (1 case). The length of surgery was significantly different (P = 0.003) between the revision surgery and the previous discectomy. There were no significant differences between revision and previous surgery in terms of hospital stay or clinical improvement rates. Age, gender, smoking, professions, traumatic events level and degree of herniation, and pain-free interval did not affect the clinical outcomes. Conclusion. Conventional open discectomy as a revision surgery for recurrent lumbar disc herniation showed satisfactory results that were comparable with those of primary discectomy. Based on the results of this study, repeat discectomy can be recommended for the management of recurrent lumbar disc herniation.

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