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Lumbar diskectomy for recurrent disk herniation

H R Silvers1, P J Lewis, H L Asch

  • 1Southtowns Neurological Surgeons Associates, Buffalo, NY 14224.

Journal of Spinal Disorders
|October 1, 1994
PubMed
Summary
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Repeat lumbar microdiskectomy for recurrent back and leg pain shows moderate success. Poor outcomes are linked to same-level, same-side reoperations, especially within one year, particularly for workers' compensation patients.

Area of Science:

  • Neurosurgery
  • Orthopedics
  • Spinal Surgery

Background:

  • Recurrent back and leg pain after lumbar microdiskectomy presents a clinical challenge.
  • Reoperation rates for lumbar diskectomy vary, necessitating evaluation of outcomes.

Purpose of the Study:

  • To evaluate the long-term outcomes of repeat lumbar microdiskectomy for recurrent back and leg pain.
  • To identify factors predicting poor outcomes in patients undergoing reoperation.

Main Methods:

  • Retrospective review of 82 patients undergoing reoperation for recurrent lumbar disk issues.
  • Exclusion of patients with spinal fusion or diskectomy for spinal stenosis.
  • Long-term outcomes assessed via questionnaires (68 responses, 83% compliance).

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Main Results:

  • Overall reoperation rate was 7.4%; same-level, same-side recurrence was 4.5%.
  • Successful leg pain relief: 56%; back pain relief: 54%; return to work: 44%; return to normal activity: 51%; overall satisfaction: 73%.
  • Poor outcomes significantly correlated with same-level, same-side reoperation and short (<1 year) interval between surgeries.

Conclusions:

  • Repeat lumbar microdiskectomy can provide pain relief and functional improvement for recurrent disk issues.
  • Same-level, same-side recurrence within one year, especially in workers' compensation cases, indicates a high risk of poor surgical outcomes.
  • Careful patient selection is crucial for repeat lumbar diskectomy procedures.