Recurrence Rate after Herniotomy only versus Discectomy in Lumbar Disc Herniation

Abstract

ObjectiveLumbar disc herniation (LDH) recurrence necessitating reoperation can pose problems following spinal surgery, with an overall reported incidence of approximately (3-13%). The purpose of this study is to identify the rate of recurrent disc herniation, to discuss the radiologic indications for herniotomy and to analyze clinical outcomes compared with conventional discectomy.MethodsThis study is a retrospective case control study. The authors retrospectively reviewed 114 patients who underwent herniotomy & conventional discectomy by a single surgeon for single-level LDH between June 2009 and May 2012. Herniotomy group was 57 patients and conventional discectomy group was 57 patients that were selected from 631 patients using stratified randomization. Evaluation for LDH recurrence included detailed medical chart and radiologic review and telephone interview. Postoperative VAS and the Korean version of ODI were examined one week after surgery. Clinical outcome was investigated according to Odom's criteria from three months to three years.ResultsOf the 114 patients for whom the authors were able to definitively assess symptomatic recurrence status, four patients (7%) experienced LDH recurrence following single-level herniotomy and three patients (5.2%) conventional discectomy. There were no differences in the VAS and Korean version of ODI between herniotomy group and conventional discectomy group. The herniotomy group had better results than the conventional discectomy group in clinical outcome from three months to three years, but the difference was not significant.ConclusionThere were no significant differences in clinical outcome between herniotomy and conventional discectomy. Recurrence rates following herniotomy for LDH compare favorably with those in patients who have undergone conventional discectomy, lending further support for its effectiveness in treating herniotomy.

Comparison of Discectomy versus Sequestrectomy in Lumbar Disc Herniation: A Meta-Analysis of Comparative Studies

“…Adequate data of post-operative VAS for low back pain with mean and SD were provided in five studies [ 13 , 19 , 21 , 24 , 25 ], which enrolled 680 patients with 388 in discectomy group and 292 in sequestrectomy group. Four studies [ 18 , 20 , 26 , 28 ] provided single mean values without SD and reported no significant difference. Our meta-analysis revealed that post-operative VAS for low back pain favored sequestrectomy with a weighted mean difference of 0.22 (95% CI 0.06–0.37, P<0.05).…”

“…Six studies apprised post operation satisfaction [ 13 , 18 , 20 , 22 , 26 , 27 ], enrolling 652 patients with 329 in discectomy group and 323 in sequestrectomy group. No significant heterogeneity was found (P = 0.45, I 2 = 0%).…”

Risk Factors and Surgical Treatment for Recurrent Lumbar Disc Prolapse: A Review of the Literature

“…Most reoperations after lumbar disc discectomy presented during the 0-0.5-year and 1-5-year periods following the primary surgery in most recurrences after primary lumbar disc discectomy presented during the 0-0.5-year followup in minimally invasive endoscopic discectomy group and 1-5-year following minimally invasive endoscopic discectomy [16]. Park et al [17] found no significant difference in the rLDH incidence of the herniotomy and conventional discectomy groups. 2) 1) Conventional discectomy Jung et al [14] and Ahsan et al [18] reported their results of conventional discectomy for rDH [14,18].…”

“…The reported incidence of recurrent disc herniation in the literature ranges from 0.5%-23% [1,2]. Many modifiable and nonmodifiable risk factors have been mentioned in various studies [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Although various surgical modalities of treatment have been practiced in treating recurrent disc herniation, significant heterogeneity exists among surgeons [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35].…”

Clinical Study of Unilateral Extraforaminal Lumbar Interbody Fusion (ELIF) Revision For Lumbar Disc Herniation After Primary Discectomy

“…However, there are still some issues after non-fusion surgery involving incomplete removing the nucleus pulposus, recurrence of intervertebral disc herniation or failed back surgery syndrome (FBSS), et al The options for revision way is still controversial. [4,5] . This study aims to introduce unilateral extraforaminal lumbar interbody fusion (ELIF) revision surgery for lumbar disc herniation after discectomy without fusion at rst time.…”