Long-term results of disc excision for recurrent lumbar disc herniation with or without posterolateral fusion.
METHODS
A retrospective study assessing the long-term outcomes of repeat surgery for recurrent lumbar disc herniation.


OBJECTIVE
To evaluate the results of repeat surgery for recurrent disc herniation, and compare the results of disc excision with and without posterolateral fusion.


BACKGROUND
The outcomes of revision surgery varied owing to the mixed patient populations. The optimal technique for treating recurrent disc herniation is controversial.


METHODS
The sample included 41 patients who underwent disc excision with or without posterolateral fusion, with an average follow-up of 88.7 months (range, 60-134 months). Clinical symptoms were assessed based on the Japanese Orthopedic Association Back Scores. All medical and surgical records were examined and analyzed, including pain-free interval, intraoperative blood loss, length of surgery, and postsurgery hospital stay.


RESULTS
Clinical outcome was excellent or good in 80.5% of patients, including 78.3% of patients undergoing a discectomy alone, and 83.3% of patients with posterolateral fusion. The recovery rate was 82.2%, and the difference between the fusion and nonfusion groups was insignificant (P = 0.799). The difference in the postoperative back pain score was also insignificant (P = 0.461). These two groups were not different in terms of age, pain-free interval, and follow-up duration. Intraoperative blood loss, length of surgery, and length of hospitalization were significantly less in patients undergoing discectomy alone than in patients with fusion.


CONCLUSIONS
Repeat surgery for recurrent sciatica is effective in cases of true recurrent disc herniation. Disc excision alone is recommended for managing recurrent disc herniation.
Fu
Tsai-Sheng
TS
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Lai
Po-Liang
PL
Tsai
Tsung-Ting
TT
Niu
Chi-Chieh
CC
Chen
Li-Huei
LH
Chen
Wen-Jer
WJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D017586:Diskectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology / Q000601:surgery*; D007405:Intervertebral Disc Displacement / Q000473:pathology / Q000517:prevention & control / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D055502:Secondary Prevention; D013123:Spinal Fusion; D013995:Time