Long-term outcome of redo discectomy for recurrent lumbar disc herniations

Cunha, Marisa; Basto, D.; Silva, P. S.; Vaz, Ruí; Pereira, Paulo

doi:10.1007/s00586-022-07493-4

Cited by 3 publications

(4 citation statements)

References 24 publications

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“…Revision surgery was characterized by a significant complication rate 13,17,18 . The primary concern in repeat disc surgery for recurrent disc herniation was adhesion and epidural or perineural scar tissue, which makes repeat surgery more difficult and increases the risk of dural tear and nerve injury 9,19 . We found fibrotic adhesions surrounding the targeted nerve root, epidural space which causes extensive bleeding when performing a discectomy.…”

Section: Discussionmentioning

confidence: 95%

“…The decision for repeat surgical intervention depends on the variations in clinical decision‐making on the part of the physician as well as the patient's perceived risks and benefits. 19 Adolescent population may prefer to avoid repeat surgery if they think that nonsurgical treatment could be successful. Revision surgery was characterized by a significant complication rate.…”

Section: Discussionmentioning

confidence: 99%

“…13,17,18 The primary concern in repeat disc surgery for recurrent disc herniation was adhesion and epidural or perineural scar tissue, which makes repeat surgery more difficult and increases the risk of dural tear and nerve injury. 9,19 We found fibrotic adhesions surrounding the targeted nerve root, epidural space which causes extensive bleeding when performing a discectomy. So, we separated the fibrotic adherent tissues carefully and bipolar electrocoagulation was applied for hemostasis in advance.…”

Section: Repeat Surgical Interventionmentioning

confidence: 96%

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Repeat Surgery after Percutaneous Endoscopic Lumbar Discectomy for Adolescent Lumbar Disc Herniation: A Multicenter Observational Study

Mao,

Wang,

Zhu

et al. 2024

Orthopaedic Surgery

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ObjectiveThe reported date in the repeat surgical intervention for adolescent lumbar disc herniation (ALDH) after percutaneous endoscopic lumbar discectomy (PELD) was quite scarce. This study aims to introduce cases of repeat surgeries after PELD for ALDH and assess the incidence, chief causes, repeat surgery methods, and surgical outcomes of repeat surgeries after PELD for ALDH.MethodsA retrospective multicenter observational study was conducted on patients undergoing repeat surgeries after PELD for ALDH at four tertiary referral hospitals from January 2014 through August 2022. The incidence of repeat surgeries, chief causes, strategies for repeat surgeries, and timing of repeat surgeries were recorded and analyzed. The clinical outcomes were evaluated by the Numeric Rating Scales (NRS) scores and the modified MacNab criteria. Statistical analyses were performed with the Wilcoxon signed‐rank test.ResultsA total of 23 patients who underwent repeat surgeries after PELD for ALDH were included. The chief causes were re‐herniation (homo‐lateral re‐herniation at the same level, new disc herniation of adjacent level). The repeat surgery methods were revision PELD, micro‐endoscopic discectomy (MED), open discectomy and instrumented lumbar inter‐body fusion. The NRS scores decreased significantly in follow‐up evaluations and these scores demonstrated significant improvement at the last follow‐up (p < 0.002). For the modified MacNab criteria, at the last follow‐up, 18 patients (78.26%) had an excellent outcome, and the overall success rate was 86.95%.ConclusionThis study's data suggest that young patients who underwent repeat surgery improved significantly compared to baseline. The chief cause was re‐herniation. Revision PELD was the main surgical procedure, which provides satisfactory clinical results in young patients who underwent repeat surgeries.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Repeat Surgical Interventionmentioning

confidence: 96%

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Repeat Surgery after Percutaneous Endoscopic Lumbar Discectomy for Adolescent Lumbar Disc Herniation: A Multicenter Observational Study

Mao,

Wang,

Zhu

et al. 2024

Orthopaedic Surgery

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“…The long-term effects of surgery for LDH in adults have previously been reported. 1 , 6 , 9 Little is, however, known about the long-term effects of LDH surgery during adolescence. Lagerbäck et al 17 previously found that adolescents who underwent surgery for LDH had increased disk degeneration and worse health outcomes at an average of 13.8 years of follow-up when compared with controls.…”

Section: Introductionmentioning

confidence: 99%

Back morphology and walking patterns mean 13.8 years after surgery for lumbar disk herniation in adolescents

Ruehr,

Blomé,

Kastrati

et al. 2024

PR9

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Introduction: In many pain conditions, there is lingering pain despite healed tissue damage. Our previous study shows that individuals who underwent surgery for lumbar disk herniation (LDH) during adolescence have worse health, more pain, and increased disk degeneration mean 13 years after surgery compared with controls. It is unclear if walking patterns segregate surgically treated LDH adolescents and controls at mean 13-year follow-up. Objectives: Here, we analyzed the relationship between gait, back morphology and other health outcomes in a cohort of individuals treated surgically because of lumbar disk herniation compared with controls. Methods: We analyzed gait during a walking paradigm, back morphology at the site of surgery, and standardized health outcomes, among individuals who received surgery for LDH as adolescents, “cases” (n = 23), compared with “controls” (n = 23). Results: There were gait differences in head (P = 0.021) and trunk angle (P = 0.021) between cases and controls in a direction where cases exhibited a posture associated with sickness. The gait variance was explained by subjective pain and exercise habits rather than objective disk degeneration. Conclusion: Over a decade after surgery for LDH during adolescence, health among cases is worse compared with controls. The head and trunk angles differ between cases and controls, indicating that the residual pain lingers and may cause changes in movement patterns long after a painful episode in early life. Gait may be a useful target for understanding maintenance of pain and disability among individuals treated surgically for LDH during adolescence.

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Letter to Editor concerning “Long-term outcome of redo discectomy for recurrent lumbar disc herniations” by Cunha et al. (Eur Spine J [2023]. https://doi.org/10.1007/s00586-022-07493-4)

et al. 2023

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Long-term outcome of redo discectomy for recurrent lumbar disc herniations

Cited by 3 publications

References 24 publications

Repeat Surgery after Percutaneous Endoscopic Lumbar Discectomy for Adolescent Lumbar Disc Herniation: A Multicenter Observational Study

Repeat Surgery after Percutaneous Endoscopic Lumbar Discectomy for Adolescent Lumbar Disc Herniation: A Multicenter Observational Study

Back morphology and walking patterns mean 13.8 years after surgery for lumbar disk herniation in adolescents

Letter to Editor concerning “Long-term outcome of redo discectomy for recurrent lumbar disc herniations” by Cunha et al. (Eur Spine J [2023]. https://doi.org/10.1007/s00586-022-07493-4)

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