Microsurgery for recurrent lumbar disk herniation at the same level and side: do patients fare worse? Experience with 95 consecutive cases

Surgical Neurology
Lucio PalmaSerena Capitani

Abstract

In reviewing our experience with reoperation of RLDH, our aim was mainly to determine whether patients fared worse than after primary surgery. We found no uniform answers to this question in the literature. The data of 95 patients (29 women and 66 men) who underwent reoperation for RLDH at the same level and side were analyzed retrospectively. Forty-two patients underwent the first operation in our clinic (recurrence rate, 2.6% of 1586 cases). Gadolinium-enhanced MRI was performed in all patients. Main clinical data of patients, pain-free interval, operation time, surgical complications, duration of hospital stay, and clinical improvement rate were recorded. The mean pain-free interval was 55 months (range, 3-120 months). Levels of recurrent herniation were L4 through L5 and L5 through S1 (65% and 35% of cases, respectively). Revision surgery lasted longer on average than the previous diskectomy (P < .01) and was complicated by dural tear in 4 cases (4.2% vs 0.9% during primary diskectomy, P < .05). There were no significant differences between revision and previous surgery in terms of hospital stay. However, rates of excellent/good outcomes were significantly less for RLDH (89% vs 95%, P < .05); and the percentage of poor resu...Continue Reading

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Citations

Sep 21, 2013·Asian Journal of Neurosurgery·Mohammad ShimiaAfshin Habibzadeh
Sep 26, 2015·The American Journal of Medicine·Rahman Shiri, Kobra Falah-Hassani
Aug 19, 2015·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Ashraf DowerMark J Winder
Mar 24, 2016·Clinical Spine Surgery : a Spine Publication·Hiroyuki YoshiharaThomas J Errico

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