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

Abstract

Background: Revision discectomy is the principal procedure for recurrent lumbar disk herniation (RLDH). The clinical<br />outcomes after this procedure are as good as or slightly poorer than those produced by primary discectomy. In this<br />study, the clinical outcomes of patients treated with microsurgical discectomy for RLDH were analyzed.<br />Methods: We examined 179 patients undergoing lumbar microdiscectomy surgery for RLDH. The visual analogue<br />scale (VAS), Prolo scoring system, and Oswestry Disability Index (ODI) were used for evaluating the improvement<br />of symptoms and functional outcomes.<br />Results: Among 179 patients, 101 (56%) obtained good and excellent Prolo scores (group 1), while 78 (44%)<br />obtained fair or poor results (group 2). There was no significant difference between the groups regarding age<br />(P=0.515), gender (P=0.545), body mass index (P=0.523), diabetes mellitus (P=0.074), smoking (P=0.100),<br />interval between primary and revision surgeries (P=0.749), and surgical outcomes (P=0. 749). However, significant<br />improvements were achieved in VAS scores for back (P=0.197) and radicular pain (P=0.606), as well as ODI scores<br />(P= 0.000). Based on the findings, only ODI scores showed a significant inter-group difference in the 12-month<br />follow-up (P=0.038).<br />Conclusion: Limited microsurgical discectomy could be considered as the main surgical method in patients with RLDH<br />without overt instabilities.<br />Level of evidence: IV