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Contralateral reherniation after open lumbar microdiscectomy : a comparison with ipsilateral reherniation
Kyeong Bo Choi1, Dong Yeob Lee, Sang-Ho Lee
1Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Korea.
Journal of Korean Neurosurgical Society
|January 3, 2009
Summary
Contralateral reherniations after open lumbar microdiscectomy (OLM) are linked to longer intervals from initial surgery and mild disc degeneration. Revision OLM outcomes were similar for both contralateral and ipsilateral reherniations.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Orthopedics
Background:
- Recurrent lumbar disc herniation is a common complication after open lumbar microdiscectomy (OLM).
- Contralateral reherniation presents unique challenges compared to ipsilateral reherniation.
- Understanding risk factors for contralateral reherniation is crucial for patient management.
Purpose of the Study:
- To identify risk factors associated with contralateral reherniations post-OLM.
- To compare the clinical and radiological factors between contralateral and ipsilateral reherniations.
- To evaluate and compare surgical outcomes of revision OLM for both types of reherniation.
Main Methods:
- Retrospective analysis of 17 patients with contralateral reherniation (Group I) and 35 with ipsilateral reherniation (Group II) undergoing revision OLM.
- Evaluation of clinical and radiological factors from medical charts and imaging studies.
- Comparison of clinical outcomes between the two groups post-revision surgery.
Main Results:
- A significant difference in the interval to reherniation was observed (33 months for contralateral vs. 18.6 months for ipsilateral, p=0.009).
- Higher incidences of protruded disc (35.3% vs. 8.6%, p=0.045) and mild disc degeneration (29.4% vs. 5.7%, p=0.031) were noted at initial surgery for contralateral reherniation.
- Multivariable analysis identified interval to reherniation (OR=1.051) and mild disc degeneration (OR=12.03) as significant predictors for contralateral reherniation.
Conclusions:
- The time interval from initial surgery and the initial grade of disc degeneration are key factors differentiating contralateral from ipsilateral reherniations.
- Revision open lumbar microdiscectomy yields similar positive clinical outcomes for both contralateral and ipsilateral reherniations.
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