Clinical Outcomes after Microdiscectomy for Recurrent Lumbar Disk Herniation: A Single-Center Study | ||
The Archives of Bone and Joint Surgery | ||
مقاله 10، دوره 6، شماره 5، آذر 2018، صفحه 397-401 اصل مقاله (380.34 K) | ||
نوع مقاله: RESEARCH PAPER | ||
شناسه دیجیتال (DOI): 10.22038/abjs.2017.24932.1666 | ||
نویسندگان | ||
Hosein Mashhadinejad1؛ Ebrahim Sarabi1؛ Sara Mashhadinezhad2؛ Babak Ganjeifar* 1 | ||
1Department of Neurological Surgery, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran | ||
2Department of Cardiology, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran | ||
چکیده | ||
Background: Revision discectomy is the principal procedure for recurrent lumbar disk herniation (RLDH). The clinical outcomes after this procedure are as good as or slightly poorer than those produced by primary discectomy. In this study, the clinical outcomes of patients treated with microsurgical discectomy for RLDH were analyzed. Methods: We examined 179 patients undergoing lumbar microdiscectomy surgery for RLDH. The visual analogue scale (VAS), Prolo scoring system, and Oswestry Disability Index (ODI) were used for evaluating the improvement of symptoms and functional outcomes. Results: Among 179 patients, 101 (56%) obtained good and excellent Prolo scores (group 1), while 78 (44%) obtained fair or poor results (group 2). There was no significant difference between the groups regarding age (P=0.515), gender (P=0.545), body mass index (P=0.523), diabetes mellitus (P=0.074), smoking (P=0.100), interval between primary and revision surgeries (P=0.749), and surgical outcomes (P=0. 749). However, significant improvements were achieved in VAS scores for back (P=0.197) and radicular pain (P=0.606), as well as ODI scores (P= 0.000). Based on the findings, only ODI scores showed a significant inter-group difference in the 12-month follow-up (P=0.038). Conclusion: Limited microsurgical discectomy could be considered as the main surgical method in patients with RLDH without overt instabilities. Level of evidence: IV | ||
کلیدواژهها | ||
Disc herniation؛ lumbar؛ Outcome assessment؛ Recurrence؛ Revision surgery | ||
مراجع | ||
1. Suk KS, Lee HM, Moon SH, Kim NH. Recurrent lumbar disc herniation: results of operative management. Spine. 2001; 26(6):672-6. 2. Dai LY, Zhou Q, Yao WF, Shen L. Recurrent lumbar disc herniation after discectomy: outcome of repeat discectomy. Surg Neurol. 2005; 64(3):226-31. 3. Dower A, Chatterji R, Swart A, Winder MJ. Surgical management of recurrent lumbar disc herniation and the role of fusion. J Clin Neurosci. 2016; 23(4):44-50. 4. Law JD, Lehman RA, Kirsch WM. Reoperation after lumbar intervertebral disc surgery. J Neurosurger. 1978; 48(2):259-63. 5. Ebeling U, Kalbarcyk H, Reulen HJ. Microsurgical reoperation following lumbar disc surgery: timing, surgical findings, and outcome in 92 patients. J Neurosurg. 1989; 70(3):397-404. 6. Gaston P, Marshall RW. Survival analysis is a better estimate of recurrent disc herniation. J Bone Joint Surg Br. 2003; 85(4):535-7. 7. Buchmann N, Preuß A, Gempt J, Ryang YM, Vazan M, Stoffel M, et al. Outcome after surgical treatment for late recurrent lumbar disc herniations in standard open microsurgery. World Neurosurg. 2016; 89(2):382-6. 8. Palma L, Carangelo B, Muzii VF, Mariottini A, Zalaffi A, Capitani S. Microsurgery for recurrent lumbar disk herniation at the same level and side: do patients fare worse? Experience with 95 consecutive cases. Surg Neurol. 2008; 70(6):619-21. 9. Patel M, Braybrooke J, Newey M, Sell P. A comparative study of the outcomes of primary and revision lumbar discectomy surgery. Bone Joint J. 2013; 95(1):90-4. 10. Fairbank JC, Pynsent PB. The Oswestry disability index. Spine. 2000; 25(22):2940-52. 11. Vanti C, Prosperi D, Boschi M. The Prolo Scale: history, evolution and psychometric properties. J Orthop Traumatol. 2013; 14(4):235-45. 12. Mullin BB, Rea GL, Irsik R, Catton M, Miner ME. The effect of postlaminectomy spinal instability on the outcome of lumbar spinal stenosis patients. J Spinal Disord. 1996; 9(2):107-16. 13. Grogan J, Nowicki BH, Schmidt TA, Haughton VM. Lumbar facet joint tropism does not accelerate degeneration of the facet joints. AJNR Am J Neuroradiol. 1997; 18(7):1325-9. 14. Mroz TE, Lubelski D, Williams SK, O’Rourke C, Obuchowski NA, Wang JC, et al. Differences in the surgical treatment of recurrent lumbar disc herniation among spine surgeons in the United States. Spine J. 2014; 14(10):2334-43. 15. Hackla S, Malik FH, Basu S, Gupta AK. Correlation of canal dimension with neurological status and surgical outcome in lumbar pivd. J Orthop Ther. 2018; (10):2575-8241. 16. Baba H, Chen Q, Kamitani K, Imura S, Tomita K. Revision surgery for lumbar disc herniation. Int Orthop. 1995; 19(2):98-102. 17. Fu TS, Lai PL, Tsai TT, Niu CC, Chen LH, Chen WJ. Longterm results of disc excision for recurrent lumbar disc herniation with or without posterolateral fusion. Spine. 2005; 30(24):2830-4. 18. Guan J, Ravindra VM, Schmidt MH, Dailey AT, Hood RS, Bisson EF. Comparing clinical outcomes of repeat discectomy versus fusion for recurrent disc herniation utilizing the N2QOD. J Neurosurg Spine. 2017; 26(1):39-44. 19. Ibrahim M, Arockiaraj J, Amritanand R, Venkatesh K, David KS. Recurrent lumbar disc herniation: results of revision surgery and assessment of factors that may affect the outcome. A non-concurrent prospective study. Asian Spine J. 2015; 9(5):728-36. 20. Guo JJ, Yang H, Tang T. Long-term outcomes of the revision open lumbar discectomy by fenestration: A follow-up study of more than 10 years. Int Orthop. 2009; 33(5):1341-5. 21. Ozgen S, Naderi S, Ozek MM, Pamir MN. Findings and outcome of revision lumbar disc surgery. J Spinal Disord. 1999; 12(4):287-92. 22. Wera GD, Marcus RE, Ghanayem AJ, Bohlman HH. Failure within one year following subtotal lumbar discectomy. J Bone Joint Surg Am. 2008; 90(1):10-5. 23. Lee DY, Shim CS, Ahn Y, Choi YG, Kim HJ, Lee SH. Comparison of percutaneous endoscopic lumbar discectomy and open lumbar microdiscectomy for recurrent disc herniation. J Korean Neurosurg Soc. 2009; 46(6):515-21. 24. McGirt MJ, Ambrossi GL, Datoo G, Sciubba DM, Witham TF, Wolinsky JP, et al. Recurrent disc herniation and long‐term back pain after primary lumbar discectomy: review of outcomes reported for limited versus aggressive disc removal. Neurosurgery. 2009; 64(2):338-45. 25. El Shazly AA, El Wardany MA, Morsi AM. Recurrent lumbar disc herniation: a prospective comparative study of three surgical management procedures. Asian J Neurosurg. 2013; 8(3):139-46. | ||
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