Failure within one year following subtotal lumbar discectomy

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Surgery

Background:

• Reherniation within one year post-subtotal lumbar discectomy is uncommon.
• This study evaluates clinical outcomes following early recurrent lumbar disc herniation.

Purpose of the Study:

• To assess the clinical outcomes and reoperation rates in patients experiencing early reherniation after subtotal lumbar discectomy.
• To compare the outcomes of reoperation for recurrent disc herniation with those of uncomplicated primary discectomy.

Main Methods:

• Retrospective analysis of 1320 patients undergoing primary subtotal lumbar discectomy.
• Evaluation of 14 patients with reherniation within 12 months, assessing neurologic status, reoperation, and subjective outcomes.
• Comparison with 29 control patients who had uncomplicated discectomy, using Oswestry scores and modified McNab criteria.

Main Results:

• Fourteen cases (1%) of recurrent lumbar disc herniation were identified within one year.
• All patients experienced symptom relief after the initial procedure, with reherniations occurring at the same spinal level.
• Reoperation outcomes, including Oswestry scores and modified McNab criteria, were comparable between the recurrent herniation group and controls.

Conclusions:

• The incidence of early reherniation after subtotal lumbar discectomy is low.
• Consideration of iatrogenic instability is crucial during surgical treatment for reherniation.
• Reoperation for early recurrent lumbar disc herniation yields clinical outcomes similar to uncomplicated primary discectomy.