Related Experiment Video
Updated: May 11, 2026
Multilevel Oblique Lumbar Interbody Fusion in Degenerative Lumbar Disc Disease with Instability
Published on: July 25, 2025
Recurrent lumbar disc herniation treated with interspinous fusion and instrumentation: a case series
Jeffery S Oppenheim1, James Mills2
1Instructor in Neurosurgery Columbia University College of Physicians and Surgeons Chief, Section of Neurosurgery Good Samaritan Hospital Suffern, NY.
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.
Insights
Repeat micro lumbar discectomy with interspinous fusion effectively reduced disability in recurrent disc herniation patients. This surgical approach demonstrated significant Oswestry Disability Index improvements with no major complications.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Surgery
Background:
- Recurrent lumbar disc herniation after initial discectomy presents a significant clinical challenge.
- Conservative management often fails in these complex cases, necessitating surgical revision.
Observation:
- A case series evaluated four patients with recurrent lumbar disc herniation undergoing repeat micro lumbar discectomy (MLD) and interspinous process fusion.
- Preoperative and postoperative Oswestry Disability Index (ODI) scores were assessed, alongside complications and surgical outcomes.
Findings:
- Patients showed a substantial reduction in mean ODI scores from 83.5 preoperatively to 37.0 postoperatively.
- The procedure resulted in minimal blood loss, short hospital stays (mean 1 day), and no intraoperative or postoperative complications.
- At a mean follow-up of 12.9 months, no patients experienced symptomatic recurrence or instability.
Implications:
- Repeat MLD combined with interspinous fusion appears to be a safe and effective option for managing recurrent lumbar disc herniation.
- This technique offers significant functional improvement and addresses instability in previously operated patients.
- Further research with larger cohorts is warranted to confirm these findings.
