Hossein Mashhadinezhad1,2,3, Ebrahim Sarabi1,2,3, Sara Mashhadinezhad1,2,3, Babak Ganjeifar1,2,3. 1. Research performed at Ghaem Hospital, Mashhad, Iran. 2. Department of Neurological Surgery, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran. 3. Department of Cardiology, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran.
Abstract
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.
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.
Entities:
Keywords:
Disc herniation; Lumbar; Outcome assessment; Recurrence; Revision surgery
Authors: Thomas E Mroz; Daniel Lubelski; Seth K Williams; Colin O'Rourke; Nancy A Obuchowski; Jeffrey C Wang; Michael P Steinmetz; Alfred J Melillo; Edward C Benzel; Michael T Modic; Robert M Quencer Journal: Spine J Date: 2014-01-23 Impact factor: 4.166