Primary and Revision Lumbar Discectomy: A Four-Year Review from Our Private Practice

The surgical treatment of symptomatic lumbar disc herniation is now focused on nerve root decompression with preservation of the bony and ligamentous stabilizers of the spine. Various techniques of discectomy have been devised in accordance with this principle and irrespective of the technique used; primary disc surgeries have generally known to give good results. This retrospective study was done in different private clinics & hospitals of Dhaka city, Bangladesh from January 2012 to December 2015. Of the 105 lumbar discectomies performed during the study period, 95(90.4%) patients fulfilled the inclusion criteria and were included in the analysis. Of these, 90 patients had primary discectomy, while the remaining 5 were revision surgeries. The follow-up varied from 1-4 years, but the clinical outcomes were evaluated at the end of one year from surgery in all the patients. In the primary surgery group there were 50(55.56%) men and 40(44.44%) women, while the revision group had 01(20%) men and 04(80%) women. The age distribution was similar in both the groups, with the maximum numbers (44% and 42.9%) in the fourth decade of life. Of the 05 patients who underwent revision surgery, 03 belonged to the primary surgery group of this study, while the remaining 02 had undergone their primary surgery elsewhere. Excluding the two residual discs, the remaining 03 patients with recurrences gave a history of complete resolution of symptoms after the primary surgery. Amongst these, 3(60%) had a history of a precipitating event prior to onset of pain, 2 had a definitive history of significant lack of physical activity. The time interval between the primary and revision surgery ranged from three months to 10 years (average 2.6 years).