Treatment Outcome of Reoperative Lumbar Disc Herniation / 대한척추외과학회지

ABSTRACT

STUDY DESIGN: A retrospective study. OBJECTIVES: To analyze the causes and treatment outcomes of reoperation after a lumbar discectomy. SUMMARY OF LITERATURE REVIEW The major causes of reoperation after a lumbar disc surgery is recurrent disc herniation. Satisfactory outcomes can be obtained with reoperation for patients still requiring treatment. MATERIALS AND METHODS: Fifty two patients, who had undergone reoperations after lumbar discectomies with a minimum followup period of one year, were reviewed. The causes of the reoperation were analyzed according to the physical examination and conventional radiographic evaluation. The surgical outcome was assessed using the JOA score and Kirkaldy-Willis criteria, and the recovery rate was calculated according to the JOA score. Statistical analysis was carried out to evaluate the factors that might influence the outcome of reoperation. RESULTS: The causes of reoperation after lumbar disc surgery included 46 cases of recurrent disc herniation, each two cases of the wrong level, spinal canal stenosis and lumbar instability. The average JOA score increased from 11 to 24, and the average recovery rate was approximately 72%. According to the Kirkaldy-Willis criteria, the results were excellent and good in approximately 85% of cases. Statistical analysis revealed that the factors associated with a successful outcome were a single previous surgical procedure (p.0.02), a preoperative JOA score over 10 points (p.0.01), and a pain-free interval of more than 12 months after the previous operation(p.0.01). CONCLUSION: The treatment outcomes of reoperative lumbar disc herniation were satisfactory. Factors, such as the low number of prior procedures, high preoperative JOA score, and long pain-free interval after a previous operation, can lead to a successful treatment outcome of reoperation.