Recurrent lumbar disk herniation.
Recurrent lumbar disk herniation is the most common complication following primary open diskectomy. It is defined as recurrent back and/or leg pain after a definite pain-free period lasting at least 6 months from initial surgery. Careful neurologic examination is critical, and laboratory tests should be ordered to evaluate for infection. Imaging demonstrates disk herniation at the previously operated level. It is important to differentiate recurrent disk herniation from postoperative epidural scar because the latter may not benefit from reoperation. Treatment of recurrent lumbar disk herniation includes aggressive medical management and surgical intervention. Surgical techniques include conventional open diskectomy, minimally invasive open diskectomy, and open diskectomy with fusion. Fusion is necessary in the presence of concomitant segmental instability or significant foraminal stenosis resulting from disk space collapse.
Lee
Joseph K
JK
Department of Orthopaedic Durgery, New York-Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA.
Amorosa
Louis
L
Cho
Samuel K
SK
Weidenbaum
Mark
M
Kim
Yongjung
Y
D003952:Diagnostic Imaging; D017586:Diskectomy / Q000009:adverse effects*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D008159:Lumbar Vertebrae; D009460:Neurologic Examination; D012008:Recurrence; D012086:Reoperation; D012307:Risk Factors