Recurrence Rate after Herniotomy only versus Discectomy in Lumbar Disc Herniation

Area of Science:

• Neurosurgery
• Spinal Surgery
• Orthopedics

Background:

• Recurrent lumbar disc herniation (LDH) after surgery necessitates reoperation, occurring in 3-13% of cases.
• Identifying optimal surgical techniques for LDH is crucial for improving patient outcomes and reducing revision rates.

Purpose of the Study:

• To determine the recurrence rate of LDH following herniotomy compared to conventional discectomy.
• To evaluate radiologic indications for herniotomy.
• To analyze and compare clinical outcomes between herniotomy and conventional discectomy for LDH.

Main Methods:

• Retrospective case control study of 114 patients with single-level LDH undergoing herniotomy or conventional discectomy.
• Patients were selected via stratified randomization from a larger cohort.
• Recurrence assessment included medical charts, radiologic review, and telephone interviews; clinical outcomes were evaluated using VAS, ODI, and Odom's criteria.

Main Results:

• Symptomatic recurrence occurred in 7% of the herniotomy group and 5.2% of the conventional discectomy group.
• No significant differences were observed in postoperative pain (VAS) or functional status (ODI) between the two groups.
• While the herniotomy group showed a trend towards better long-term clinical outcomes, the difference was not statistically significant.

Conclusions:

• Herniotomy and conventional discectomy yield comparable clinical outcomes for single-level LDH.
• Herniotomy demonstrates favorable recurrence rates for LDH, supporting its efficacy as a surgical option.
• The study supports herniotomy as an effective treatment for lumbar disc herniation with comparable recurrence rates to conventional discectomy.