title: Recurrence Rate after Herniotomy only versus Discectomy in Lumbar Disc Herniation.
abstract: OBJECTIVE
  Lumbar disc herniation (LDH) recurrence necessitating reoperation can pose problems following spinal surgery, with an overall reported incidence of approximately (3-13%). The purpose of this study is to identify the rate of recurrent disc herniation, to discuss the radiologic indications for herniotomy and to analyze clinical outcomes compared with conventional discectomy.
  
  
  METHODS
  This study is a retrospective case control study. The authors retrospectively reviewed 114 patients who underwent herniotomy & conventional discectomy by a single surgeon for single-level LDH between June 2009 and May 2012. Herniotomy group was 57 patients and conventional discectomy group was 57 patients that were selected from 631 patients using stratified randomization. Evaluation for LDH recurrence included detailed medical chart and radiologic review and telephone interview. Postoperative VAS and the Korean version of ODI were examined one week after surgery. Clinical outcome was investigated according to Odom's criteria from three months to three years.
  
  
  RESULTS
  Of the 114 patients for whom the authors were able to definitively assess symptomatic recurrence status, four patients (7%) experienced LDH recurrence following single-level herniotomy and three patients (5.2%) conventional discectomy. There were no differences in the VAS and Korean version of ODI between herniotomy group and conventional discectomy group. The herniotomy group had better results than the conventional discectomy group in clinical outcome from three months to three years, but the difference was not significant.
  
  
  CONCLUSIONS
  There were no significant differences in clinical outcome between herniotomy and conventional discectomy. Recurrence rates following herniotomy for LDH compare favorably with those in patients who have undergone conventional discectomy, lending further support for its effectiveness in treating herniotomy.
authors.affiliation: Department of Neurosurgery, Thejoeun Hospital, Seoul, Korea.
authors.forename: Jong Soo
authors.initials: JS
authors.lastname: Park
authors.affiliation: College of Pharmacy, Korea University, Sejong-si, Korea.
authors.forename: Sang Eun
authors.initials: SE
authors.lastname: Choi
authors.affiliation: Department of Neurosurgey, Nanoori Hospital, Seoul, Korea.
authors.forename: Tae Koo
authors.initials: TK
authors.lastname: Cho
authors.affiliation: Department of Neurosurgey, Nanoori Hospital, Seoul, Korea.
authors.forename: Sang-Hyuk
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Neurosurgey, Nanoori Hospital, Seoul, Korea.
authors.forename: Wootack
authors.initials: W
authors.lastname: Rhee
authors.affiliation: Department of Neurosurgey, Nanoori Hospital, Seoul, Korea.
authors.forename: Woo Jae
authors.initials: WJ
authors.lastname: Kim
authors.affiliation: Department of Neurosurgey, Nanoori Hospital, Seoul, Korea.
authors.forename: Seong Il
authors.initials: SI
authors.lastname: Ha
authors.affiliation: Department of Neurosurgey, Nanoori Hospital, Seoul, Korea.
authors.forename: Jae Hyeon
authors.initials: JH
authors.lastname: Lim
authors.affiliation: Department of Neurosurgey, Nanoori Hospital, Seoul, Korea.
authors.forename: Il Tae
authors.initials: IT
authors.lastname: Jang
keywords: Diskectomy; Herniated Disc; Lumbar Vertebrae; Recurrence