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A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations
Published on: August 7, 2018
Outcome after repeat lumbar microdiscectomy
M M Haglund1, A J Moore, H Marsh
1Department of Neurological Surgery, University of Washington, Seattle, USA.
Abstract:
One of the standard treatments for herniation of lumbosacral disc material has become the microdiscectomy. Although multiple studies have assessed the outcome of microdiscectomy, only a few studies have evaluated the outcome of those patients who have undergone a second microdiscectomy at the same location as the original one. The purpose of this study was to review 55 patients who, over a 4-year period, underwent a second microdiscectomy at the same location as their original operation and to evaluate those factors associated with improved outcomes. The results showed the overall outcome to include 86% with complete or partial relief of all pain symptoms; 88% with complete or partial relief of sciatica; 85% with complete or partial relief of back pain; 100% returning to work in an average of 7 weeks; and 89% were glad they had the second operation. Those factors without predictive value included age, sex, weight, height, level of operation, side of operation, surgeon at the first or second operation (e.g. consultant or junior staff), length of the first operation ( < or = 60 min or > 60 min) and duration of symptoms before the first operation. The key features centred on preoperative job status, the interval between recurrence of symptoms and the second operation, and the duration of the second operation ( < or = 90 min).(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
A second microdiscectomy for lumbar disc herniation offers significant pain relief and return to work for most patients. Key factors for success include preoperative job status and timely reoperation.
Area of Science:
- Neurosurgery
- Orthopedics
- Spinal Surgery
Background:
- Microdiscectomy is a standard treatment for lumbar disc herniation.
- Few studies have evaluated outcomes of repeat microdiscectomy at the same spinal level.
Purpose of the Study:
- To review outcomes of 55 patients undergoing a second microdiscectomy at the same location.
- To identify factors associated with improved outcomes after repeat lumbar microdiscectomy.
Main Methods:
- Retrospective review of 55 patients who had a second microdiscectomy at the same spinal level.
- Analysis of patient data including demographics, symptom duration, operative details, and outcomes.
Main Results:
- 86% reported complete/partial relief of pain, 88% relief of sciatica, 85% relief of back pain.
- 100% returned to work within an average of 7 weeks; 89% were glad they had the second operation.
- Preoperative job status, symptom recurrence interval, and second operation duration (<90 min) were key predictive factors.
Conclusions:
- Repeat microdiscectomy at the same spinal level is effective for lumbar disc herniation.
- Patient selection and surgical timing are crucial for successful outcomes in revision microdiscectomy.
