title: Recurrent lumbar disc herniation treated with interspinous fusion and instrumentation: a case series.
abstract: OBJECTIVE
  This case series assesses the pre- and postoperative disability outcomes and complications after repeat micro lumbar discectomy (MLD) combined with an interspinous process fusion in patients with recurrent lumbar disc herniation.
  
  
  METHODS
  Four consecutive patients with recurrent lumbar disc herniation subsequent to their primary discectomy, who failed conservative nonoperative management, underwent repeat MLD and posterior instrumented fusion with an interspinous process plate. Before surgery and at follow-up, patients completed the Oswestry Disability Index (ODI). Demographic information, length of stay, estimated blood loss, and intraoperative and postoperative complications were recorded.
  
  
  RESULTS
  The mean patient age was 45 years. Patients experienced minimal blood loss during surgery. There were no intraoperative or postoperative complications. Mean operating time was 136 minutes. Mean hospital stay was 1 day. Mean ODI score was reduced from 83.5 preoperatively to 37.0 postoperatively at a mean follow-up time of 12.9 months. As of last follow-up (mean 387 days), no patient has had symptomatic recurrence of herniation or evidence of subsequent instability.
authors.affiliation: Instructor in Neurosurgery Columbia University College of Physicians and Surgeons Chief, Section of Neurosurgery Good Samaritan Hospital Suffern, NY.
authors.forename: Jeffery S
authors.initials: JS
authors.lastname: Oppenheim
authors.affiliation: Hudson Valley Brain and Spine Surgery Suffern, New York.
authors.forename: James
authors.initials: J
authors.lastname: Mills
mesh_terms: D000328:Adult; D001860:Bone Plates / Q000009:adverse effects; D001863:Bone Screws / Q000009:adverse effects; D005260:Female; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects*; D055959:Intervertebral Disc Degeneration / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D007405:Intervertebral Disc Displacement / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology* / Q000517:prevention & control*; D011475:Prosthesis Failure; D012086:Reoperation / Q000009:adverse effects; D013123:Spinal Fusion / Q000009:adverse effects* / Q000295:instrumentation*; D017211:Treatment Failure