Ipsilateral recurrent lumbar disc herniation

Cinotti, Gianluca; Roysam, G. S.; Eisenstein, S. M.; Postacchini, Franco

doi:10.1302/0301-620x.80b5.8540

Cited by 150 publications

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“…None of the patients had a poor result, although three patients had transient neurological deficits, which were completely resolved within 3 months. These are comparable with the rates of satisfactory clinical results reported by others [2,3,12,15].…”

Section: Discussionsupporting

confidence: 91%

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Surgical treatment of recurrent lumbar disc herniation by transforaminal lumbar interbody fusion

Chen

Zhao

Ai-gang

et al. 2008

International Orthopaedics (SICO

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Between 2001 and 2005, 43 patients (average age 54.2, range 36-68 years) with recurrent lumbar disc herniation underwent reoperation with the transforaminal lumbar interbody fusion (TLIF) technique at our unit. All cases were followed up for 24-72 months (mean 45 months) and graded using the Japanese Orthopaedic Association (JOA) score system pre-and post-operation and during the follow-up period. The leg pain of all patients was relieved significantly within one month postoperatively. The mean JOA score was improved from 9.3 before surgery to 25.0 at the final follow-up visit (P<0.0001). The average recovery rate was 86.0% (range 52-100%). General clinical outcome was excellent in 23 (53.5%) patients, good in 14 (32.6%) and fair in 6 (13.9%). The fusion rate was 100% two years postoperatively. Three patients (7%) had transient neurological deficits, which resolved completely within 3 months. There were no major complications. We, therefore, believe the TLIF technique to be an effective procedure with satisfactory clinical results for the treatment of recurrent lumbar disc herniation.Résumé Entre 2001 et 2005, 43 patients (âge moyen 54,2 ans entre 36 à 68 ans) ont bénéficié d'une réintervention chirurgicale avec arthrodèse inter corporéale par technique transforaminale pour récidive de hernie discale lombaire. Tous ces patients ont été suivis en moyenne pendant 45 mois et évalués selon le score de la JOA en pré et post opératoire. Les douleurs des membres de tous ces patients ont été nettement améliorées dans le premier mois post opératoire. Le score de la JOA a été également améliorée de 9,3 avant l'intervention à 25 lors de la dernière revue de ces malades (P<0,0001). Le taux moyen de récupération a été de 86% (52 à 100%). L'évolution clinique générale a été excellente chez 23 patients (53,5%), bonne chez 14 patients (32,6%) et médiocre chez 6 patients (13,9%). Le taux de fusion a été de 100% en post opératoire. 3 patients (7%) ont eu des troubles neurologiques transitoires qui ont complète-ment régressé dans les trois mois. Il n'y a pas eu de complications majeures. L'étude technique TLIF est une technique efficace qui nous donne satisfaction dans le traitement des récidives de hernies discales lombaires.

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Section: Discussionsupporting

confidence: 91%

“…Recurrent lumbar disc herniation (RLDH) is a major cause of surgical failure, the incidence of which is reported from 5 to 11%, with an increased incidence as the follow-up period is extended [2,5,13]. The optimal technique for treating RLDH is controversial.…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment of recurrent lumbar disc herniation by transforaminal lumbar interbody fusion

Chen

Zhao

Ai-gang

et al. 2008

International Orthopaedics (SICO

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“…For example, Ayman A. El Shazlyand colleagues (6) reported that patient outcomes following reoperative discectomy were satisfactory and similar to those in patients treated with primary disc excision. Cinotti and colleagues (7) reported an overall good outcome rate of 85% and a return-to work rate of 81% among 26 patients who had undergone reoperative discectomy. Ozgen and colleagues (8) performed reoperative decompressions in 114 patients including reoperative discectomies in 89 patients with a recurrent disc herniation.…”

Section: Discussionmentioning

confidence: 98%

Evaluation of Treatment of Recurrent Lumbar Disc Prolapse: Fusion Versus Non Fusion

Khayat¹,

Khallaf²,

Hassan³

et al. 2017

IAM

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Background: Recurrent lumbar disc herniation is one of the most common spinal disorders. The management of recurrent lumbar disc herniation remains somewhat controversial. Surgical treatment for recurrent disc herniation can be broadly categorized as revision discectomy alone or revision discectomy and fusion. Objective: The aim of the work is the evaluation of management of recurrent lumbar disc prolapse: fusion versus non-fusion aiming to reach ideal method of treatment. Matients and Methods: This is a prospective, randomized, comparative study on 30 patients (19 M, 11 F) with recurrent lumbar disc herniation at Assiut University Hospitals from January 2015 to January 2016 (minimum 12-months follow-up) with an average age of 47.2 years (range: 30-67 years). The patients were classified into 2 groups: Group A (15 patients); who had revision discectomy alone, group B (15 patients); who had revision discectomy with fusion. The clinical and radiographic results were compared between the two groups. Clinical outcome was assessed using the Modified MacNab's Criteria and radiological outcome was assessed using Lenke classification. Results: Regarding postoperative Modified MacNab's Criteria, there is no significant difference (P=0.7826) between group A which was excellent in 7 cases (7/15, 46.7%), good in 6 cases (6/15, 40%) and fair in 2 cases (2/15, 13.3%) and group B which was excellent in 6 cases (6/15, 40%), good in 6 cases (6/15, 40%), fair in 2 cases (2/15, 13.3%) and poor in 1 case (1/15, 6.7%). In group A: 1 of 15 patients (6.7%) had dural tear while in group B: 3 of 15 patients (33.3%) have dural tear (P=0.6171) and no infection occur in group A while 2 patients (13.3%) have infection in group B. The intraoperative blood loss and length of operation were significantly less in group A. The post-surgery hospital stay was significantly different between the 2 groups, being least in group A and highest in group B. Conclusion: Surgery for recurrent lumbar disc herniation can be very successful and may approach the success rate for initial operations (80% in our study) provided proper patient selection, good and thorough examination and investigations and proper surgical technique.

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“…Cinotti et al 3 prospectively compared outcomes obtained in 26 patients who had undergone revision discectomy with outcomes in 50 control patients who had undergone a primary discectomy. They found no significant difference between groups; postoperative satisfaction was reported by 85% of those in the revision group and 88% in the control primary discectomy group.…”

Section: Discussionmentioning

confidence: 99%

Quality of life outcomes after revision lumbar discectomy

Lubelski

Şenol

Silverstein

et al. 2015

SPI

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OBJECT The authors investigated quality of life (QOL) outcomes after primary versus revision discectomy. METHODS A retrospective review was performed for all patients who had undergone a primary or revision discectomy at the Cleveland Clinic Center for Spine Health from January 2008 through December 2011. Among patients in the revision cohort, they identified those who needed a second revision discectomy. Patient QOL measures were recorded before and after surgery. These measures included responses to the EQ-5D health questionnaire, Patient Health Questionnaire–9, Pain and Disability Questionnaire, and quality-adjusted life years (QALYs). Cohorts were compared by using independent-sample t-tests and Fisher exact tests for continuous and categorical variables, respectively. Multivariable logistic regression was performed to adjust for confounding. RESULTS A total of 196 patients were identified (116 who underwent primary discectomy and 80 who underwent revision discectomy); average follow-up time was 150 days. There were no preoperative QOL differences between groups. Postoperatively, both groups improved significantly in all QOL measures. For QALYs, the primary cohort improved by 0.25 points (p < 0.001) and the revision cohort improved by 0.18 points (p < 0.001). QALYs improved for significantly more patients in the primary than in the revision cohort (76% vs 59%, respectively; p = 0.02), and improvement exceeded the minimum clinically important difference for more patients in the primary cohort (62% vs 45%, respectively; p = 0.03). Of the 80 patients who underwent revision discectomy, yet another recurrent herniation (third herniation) occurred in 14 (17.5%). Of these, 4 patients (28.6%) chose to undergo a second revision discectomy and the other 10 (71.4%) underwent conservative management. For those who underwent a second revision discectomy, QOL worsened according to all questionnaire scores. CONCLUSIONS QOL, pain and disability, and psychosocial outcomes improved after primary and revision discectomy, but the improvement diminished after revision discectomy.

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Ipsilateral recurrent lumbar disc herniation

Cited by 150 publications

References 0 publications

Surgical treatment of recurrent lumbar disc herniation by transforaminal lumbar interbody fusion

Surgical treatment of recurrent lumbar disc herniation by transforaminal lumbar interbody fusion

Evaluation of Treatment of Recurrent Lumbar Disc Prolapse: Fusion Versus Non Fusion

Quality of life outcomes after revision lumbar discectomy

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