Surgical outcomes for recurrent lumbar disc herniation

English Keywords:Lumbar disc herniation  Recurrent  Reoperation  Outcomes

English Abstract:

  【Abstract】　Objective：To investigate the varied surgical outcome for recurrent lumbar disc herniation．Method：From April 2004 to October 2009，78 patients with recurrent lumbar disc herniation（32 males，46 females）with the mean age of 52.2　years（range，27－79 years） were involved in this study．Patients were assigned into 3 groups according to preoperative diagnosis and revision protocols classification as followers：group A（n=27） with no lumbar vertebrae instablility or lumbar spinal stenosis and underwent discectomy alone；group B（n=15） with lumbar vertebrae instability or lumbar spinal stenosis and underwent discectomy and posterolateral fusion（PLF）；group C（n=36） with lumbar vertebrae instability or lumbar spinal stenosis and underwent discectomy and posterior lumbar interbody fusion（PLIF）；both group B and group C had vertebral pedicle screw fixation；the clinical results of all patients were analyzed by JOA score（29 score）and VAS score．Result：All patients were followed up for an average of 24 months（range，6 months－36 months）.Ｂｅｆｏｒｅ　ｓｕｒｇｅｒｙ，ｔｈｅ　JOA score for group A，B and C was　9.96±2.59，10.20±2.37　ａｎｄ　9.14±3.16 respectively；２０．３７±５．２１，２２．６０±６．６２　ａｎｄ　２１．４５±６．０９ for 2 months later respectively；and １９．８５±６．４５，２０．４０±６．４７　ａｎｄ　２０．９２±５．５１　respectively for final follow-up，which showed significant difference compared with preoperative ones（P<0.05）．Ｔhe VAS score for low back pain ａｎｄ　leg pain　in the group A，B and C showed significant difference compared with preoperative ones（P<0.05）.Conclusion：Surgical management for recurrent lumbar disc herniation（RLDH）should be individualized．