Recurrent lumbar disc protrusion

O’Sullivan, M. Gerard; Connolly, Angela E.; Buckley, T. F.

doi:10.3109/02688699008992741

Cited by 70 publications

(52 citation statements)

References 5 publications

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“…Previous reports have indicated that patients undergoing a primary discectomy have a 76%-95% chance of satisfactory results as measured by pain and functional measures, whereas only 59%-81% of those undergoing a revision discectomy will achieve the same results. 6,15,18,21,23 Although our findings suggest that QOL improvements are less for those undergoing revision discectomy than for those undergoing primary discectomy, the improvements experienced by revision discectomy patients nonetheless often exceed the MCID threshold. In contrast, QOL outcomes tend to be relatively poor for patients who experience another recurrent (third) herniation after revision discectomy.…”

Section: Discussioncontrasting

confidence: 40%

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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Section: Discussioncontrasting

confidence: 40%

Quality of life outcomes after revision lumbar discectomy

Lubelski

Şenol

Silverstein

et al. 2015

SPI

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“…PLID can recur at the same disc and side as the primary PLID 10,13 or at the same disc and contralateral side or at a new disc at different level. 9,13 Annular incision performed at primary discectomy may be a predisposing factor for recurrence, and the presence of scar tissue may affect the results of revision surgery.…”

Section: Discussionmentioning

confidence: 99%

“…9,13 Annular incision performed at primary discectomy may be a predisposing factor for recurrence, and the presence of scar tissue may affect the results of revision surgery.…”

Section: Discussionmentioning

confidence: 99%

Discectomy for Primary and Recurrent Prolapse of Lumbar Intervertebral Discs

Ahsan

Najmus-Sakeb

Hossain

et al. 2012

J Orthop Surg (Hong Kong)

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purpose. To reviewed 416 patients who underwent discectomy for primary or recurrent prolapse of lumbar intervertebral discs (PLID). Methods. Records of 296 men and 102 women aged 19 to 60 (mean, 39) years who underwent discectomy for a primary PLID, and 14 men and 4 women aged 28 to 50 (mean, 40) years who underwent revision discectomy for a recurrent ipsilateral (n=14) or contralateral (n=4) PLID at L4-5 (n=14), L5-S1 (n=3), or L3-4 (n=1) were reviewed. The pain-free interval, side and degree of herniation, operating time, length of hospital stay, and pre-and post-operative visual analogue score (VAS) for pain were recorded. Clinical outcomes were evaluated using the modified Macnab criteria and the Oswestry Disability Index. results. Patients were followed up for one to 4 years. The mean operating time was significantly longer in revision discectomy (65 vs. 141 minutes, p<0.001, unpaired t-test).

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“…High reoperation rates have been reported in the literature, and several studies have shown inferior outcomes for patients who undergo reoperation 7,12,18,21,22 . This investigation focused on improving clinicians' understanding of risks and outcomes when indicating IDH patients for surgery, thus improving long-term outcomes and minimizing unnecessary costs and morbidity associated with multiple operations.…”

Section: Risk Factors F O R Reoperation I N Pat I E N T S T R E At E mentioning

confidence: 99%