Clinical Outcomes after Microdiscectomy for Recurrent Lumbar Disk Herniation: A Single-Center Study

Background: Revision discectomy is the principal procedure for recurrent lumbar disk herniation (RLDH). The clinicaloutcomes after this procedure are as good as or slightly poorer than those produced by primary discectomy. In thisstudy, the clinical outcomes of patients treated with microsurgical discectomy for RLDH were analyzed.Methods: We examined 179 patients undergoing lumbar microdiscectomy surgery for RLDH. The visual analoguescale (VAS), Prolo scoring system, and Oswestry Disability Index (ODI) were used for evaluating the improvementof symptoms and functional outcomes.Results: Among 179 patients, 101 (56%) obtained good and excellent Prolo scores (group 1), while 78 (44%)obtained fair or poor results (group 2). There was no significant difference between the groups regarding age(P=0.515), gender (P=0.545), body mass index (P=0.523), diabetes mellitus (P=0.074), smoking (P=0.100),interval between primary and revision surgeries (P=0.749), and surgical outcomes (P=0. 749). However, significantimprovements were achieved in VAS scores for back (P=0.197) and radicular pain (P=0.606), as well as ODI scores(P= 0.000). Based on the findings, only ODI scores showed a significant inter-group difference in the 12-monthfollow-up (P=0.038).Conclusion: Limited microsurgical discectomy could be considered as the main surgical method in patients with RLDHwithout overt instabilities.Level of evidence: IV

Keywords:

Disc herniation , lumbar , Outcome assessment , Recurrence , Revision surgery