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[A contrastive study of treating single level recurrent lumbar disc herniation]
Xianzhong Meng1, Xianguo Meng, Yong Shen
1Department of Spine Surgery, Third Hospital of Hebei Medical University, Shijiazhuang Hebei, 050051, P.R. China. mspine33@yahoo.com.cn
Summary
Reoperation for recurrent lumbar disc herniation yields effective long-term outcomes. Larger vertebral plate discectomy or two-side fenestration is recommended for managing recurrent lumbar disc herniation.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Surgery
Background:
- Recurrent lumbar disc herniation presents a significant challenge in spinal surgery.
- Reoperation is often considered for persistent or recurrent symptoms.
- Evaluating long-term outcomes and comparing surgical techniques is crucial for optimizing patient care.
Purpose of the Study:
- To assess the long-term efficacy of reoperation for recurrent lumbar disc herniation.
- To compare the clinical outcomes of three different surgical methods for recurrent lumbar disc herniation.
Main Methods:
- A retrospective review of 76 patients undergoing reoperation for recurrent lumbar disc herniation.
- Patients were divided into three groups based on surgical technique: larger vertebral plate discectomy (Group A), whole vertebral discectomy (Group B), and whole vertebral discectomy with intervertebral fusion (Group C).
- Clinical outcomes were evaluated using functional assessment standards, with follow-up ranging from 36 to 96 months.
Main Results:
- Overall excellent or good clinical outcomes were achieved in 80.3% of patients, with no significant difference between the three groups.
- Group A demonstrated significantly lower intraoperative blood loss, shorter surgery time, and shorter hospitalization time compared to Groups B and C.
- Postoperative spinal instability was significantly lower in Group A (1 patient) and Group C (0 patients) compared to Group B (19 patients).
Conclusions:
- Reoperation for recurrent lumbar disc herniation is an effective treatment option.
- Larger vertebral plate discectomy or two-side fenestration (Group A) is recommended due to its favorable balance of efficacy and reduced surgical morbidity.
- While overall outcomes were similar, technique significantly impacts surgical parameters and long-term spinal stability.
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