scholarly journals Recurrent Lumbar Disc Herniation: A Narrative Review

2020 ◽  
Vol 1 (1) ◽  
Keyword(s):  
Risk Factors ◽  
Operative Treatment ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Narrative Review ◽  
Leg Pain ◽  
Epidural Fibrosis ◽  
Fusion Procedure ◽  
Recurrent Lumbar Disc Herniation

This narrative review aimed to identify various risk factors of recurrent lumbar disc herniation (rLDH) post-discectomy and its management. The rLDH has remained a challenging problem for spine surgeons. The incidence of rLDH is reported widely from 1% to 21%. Many possible patient-related, disc-related, and surgery-related risk factors may predispose the patient to rLDH. Moreover, the clinical and radiological diagnosis of rLDH can be challenging. Once the diagnosis is confirmed, and alternative diagnoses for leg pain have been ruled out, a course of initial non-operative treatment can be attempted. Compared to primary LDH, non-operative treatment is less likely to succeed in rLDH, possibly due to the associated epidural fibrosis and scarring. Various surgical options can be considered, including revision discectomy and fusion. Revision discectomy is usually the primary choice of surgery for the first recurrence. A fusion procedure can be chosen for those who have repeated reherniations or significant associated back pain. Precise patient selection is a must to achieve excellent surgical outcomes. Keywords: Lumbar disc herniation, recurrent herniation, discectomy, risk factor, Epidural fibrosis, narrative review.

Risk factors for recurrent lumbar disc herniation after discectomy

2018 ◽  
Vol 43 (4) ◽  
pp. 963-967 ◽  
Author(s):  
Eun-Ho Shin ◽  
Kyu-Jung Cho ◽  
Young-Tae Kim ◽  
Myung-Hoon Park
Keyword(s):  
Risk Factors ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Recurrent Lumbar Disc Herniation

scholarly journals Minimally invasive tubular microdiscectomy for recurrent lumbar disc herniation

2016 ◽  
Vol 24 (1) ◽  
pp. 48-53 ◽  
Author(s):  
Ulrich Hubbe ◽  
Pamela Franco-Jimenez ◽  
Jan-Helge Klingler ◽  
Ioannis Vasilikos ◽  
Christoph Scholz ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Minimally Invasive ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Operating Time ◽  
Leg Pain ◽  
P Value ◽  
Vas Scores ◽  
Recurrent Lumbar Disc Herniation

OBJECT The aim of the study was to investigate the safety and efficacy of minimally invasive tubular microdiscectomy for the treatment of recurrent lumbar disc herniation (LDH). As opposed to endoscopic techniques, namely microendoscopic and endoscopic transforaminal discectomy, this microscopically assisted technique has never been used for the treatment of recurrent LDH. METHODS Thirty consecutive patients who underwent minimally invasive tubular microdiscectomy for recurrent LDH were included in the study. The preoperative and postoperative visual analog scale (VAS) scores for pain, the clinical outcome according to modified Macnab criteria, and complications were analyzed retrospectively. The minimum follow-up was 1.5 years. Student t-test with paired samples was used for the statistical comparison of pre- and postoperative VAS scores. A p value < 0.05 was considered to be statistically significant. RESULTS The mean operating time was 90 ± 35 minutes. The VAS score for leg pain was significantly reduced from 5.9 ± 2.1 preoperatively to 1.7 ± 1.3 postoperatively (p < 0.001). The overall success rate (excellent or good outcome according to Macnab criteria) was 90%. Incidental durotomy occurred in 5 patients (16.7%) without neurological consequences, CSF fistula, or negative influence to the clinical outcome. Instability occurred in 2 patients (6.7%). CONCLUSIONS The clinical outcome of minimally invasive tubular microdiscectomy is comparable to the reported success rates of other minimally invasive techniques. The dural tear rate is not associated to higher morbidity or worse outcome. The technique is an equally effective and safe treatment option for recurrent LDH.

scholarly journals Recurrent Lumbar Disc Herniation: A Review

2017 ◽  
Vol 9 (2) ◽  
pp. 202-209 ◽  
Author(s):  
Nicholas Shepard ◽  
Woojin Cho
Keyword(s):  
Risk Factors ◽  
Surgical Management ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Cochrane Library ◽  
Disc Disease ◽  
Disc Herniations ◽  
Invasive Techniques ◽  
Recurrent Lumbar Disc Herniation

Study Design: Narrative review. Objectives: To identify the risk factors and surgical management for recurrent lumbar disc herniation using a systematic review of available evidence. Methods: We conducted a review of PubMed, MEDLINE, OVID, and Cochrane Library databases using search terms identifying recurrent lumbar disc herniation and risk factors or surgical management. Abstracts of all identified articles were reviewed. Detailed information from articles with levels I to IV evidence was extracted and synthesized. Results: There is intermediate levels III to IV evidence detailing perioperative risk factors and the optimal surgical technique for recurrent lumbar disc herniations. Conclusions: Multiple risk factors including smoking, diabetes mellitus, obesity, intraoperative technique, and biomechanical factors may contribute to the development of recurrent disc disease. There is widespread variation regarding optimal surgical management for recurrent herniation, which often include revision discectomies with or without fusion via open and minimally invasive techniques.

scholarly journals Risk Factors for Recurrent Lumbar Disc Herniation

Medicine ◽  
2016 ◽  
Vol 95 (2) ◽  
pp. e2378 ◽  
Author(s):  
Weimin Huang ◽  
Zhiwei Han ◽  
Jiang Liu ◽  
Lili Yu ◽  
Xiuchun Yu
Keyword(s):  
Risk Factors ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Recurrent Lumbar Disc Herniation

Risk factors for the need of surgical treatment of a first recurrent lumbar disc herniation

2015 ◽  
Vol 25 (5) ◽  
pp. 1403-1408 ◽  
Author(s):  
Ratko Yurac ◽  
Juan J. Zamorano ◽  
Fernando Lira ◽  
Diego Valiente ◽  
Vicente Ballesteros ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Recurrent Lumbar Disc Herniation

scholarly journals Open discectomy vs microdiscectomy for lumbar disc herniation - a protocol for a pragmatic comparative effectiveness study

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 2170 ◽  
Author(s):  
Andreas Sørlie ◽  
Sasha Gulati ◽  
Charalampis Giannadakis ◽  
Sven M. Carlsen ◽  
Øyvind Salvesen ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Relative Effectiveness ◽  
Length Of Hospital Stay ◽  
Postoperative Outcome ◽  
Leg Pain ◽  
Secondary Outcome ◽  
Clinical Registry

Introduction:  Since the introduction of lumbar microdiscectomy in the 1970’s, many studies have attempted to compare the effectiveness of this method with that of standard open discectomy with conflicting results. This observational study is designed to compare the relative effectiveness of microdiscectomy (MD) with open discectomy (OD) for treating lumbar disc herniation, -within a large cohort, recruited from daily clinical practice. Methods and analysis:   This study will include patients registered in the Norwegian Registry for Spine Surgery (NORspine). This clinical registry collects prospective data, including preoperative and postoperative outcome measures as well as individual and demographic parameters. The primary outcome is change in Oswestry disability index between baseline and 12 months after surgery. Secondary outcome measures are improvement of leg pain and changes in health related quality of life measured by the Euro-Qol-5D between baseline and 12 months after surgery, complications to surgery, duration of surgical procedures and length of hospital stay.

scholarly journals Postoperative Clinical Outcome and Risk Factors for Poor Outcome of Foraminal and Extraforaminal Lumbar Disc Herniation

2016 ◽  
Vol 59 (2) ◽  
pp. 143 ◽  
Author(s):  
Jung Sik Bae ◽  
Kyung Hee Kang ◽  
Jeong Hyun Park ◽  
Jae Hyeon Lim ◽  
Il Tae Jang
Keyword(s):  
Risk Factors ◽  
Clinical Outcome ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Poor Outcome
Sign in / Sign up

Export Citation Format

Share Document