title: Reoperations after first lumbar disc herniation surgery; a special interest on residives during a 5-year follow-up.
abstract: BACKGROUND
  The overall rate of operations after recurrent lumbar disc herniation has been shown to be 3-11%. However, little is known about the rate of residives. Thus the aim of this study was to explore the cumulative rates of re-operations and especially residive disc herniations at the same side and level as the primary disc herniation after first lumbar disc herniation surgery and the factors that influence the risk of re-operations over a five year follow-up study.
  
  
  METHODS
  166 virgin lumbar disc herniation patients (mean age 42 years, 57% males) were studied. Data on patients' initial disc operations and type and timing of re-operations during the follow-up were collected from patient files. Back and leg pain on visual analog scale and employment status were collected by questionnaires.
  
  
  RESULTS
  The cumulative rate of re-operations for lumbar disc herniation was 10.2% (95% Cl 6.0 to 15.1). The rate of residives at initial site was 7.4% (95% Cl 3.7 to 11.3) and rate of lumbar disc herniations at other sites was 3.1% (95% Cl 0.6 to 6.2). The occurrence of residive lumbar disc herniations was evenly distributed across the 5 years. Neither age, gender, preoperative symptoms, physical activity nor employment had effect on the probability of re-operation.
  
  
  CONCLUSIONS
  Seven percent of the lumbar disc patients had a residive lumbar disc operation within five years of their first operation. No specific factors influencing the risk for re-operation were found.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Jyväskylä Central Hospital, Jyväskylä, Finland. arja.hakkinen@ksshp.fi
authors.forename: Arja
authors.initials: A
authors.lastname: Häkkinen
authors.forename: Ilkka
authors.initials: I
authors.lastname: Kiviranta
authors.forename: Marko H
authors.initials: MH
authors.lastname: Neva
authors.forename: Hannu
authors.initials: H
authors.lastname: Kautiainen
authors.forename: Jari
authors.initials: J
authors.lastname: Ylinen
mesh_terms: D000328:Adult; D017586:Diskectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000503:physiopathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D010146:Pain / Q000209:etiology; D012008:Recurrence; D012086:Reoperation