Surgical Management Of Recurrent Lumbar Disc Herniation And Assessment Of Factors That May Affect The Outcome

Purpose:To evaluate the functional outcome after surgical management for recurrent lumbar disc herniation, and to analyze the factors that may affect the outcome.Methods:We retrospectively reviewed 26 patients with recurrent lumbar disc herniation, and 24 patients underwent the surgical management for RLDH. These patients were followed up for an average period of 2.0 years. The Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS) and patients’satisfactory degree were used to assess the functional outcome. Age, gender, smoking, hypertension, previous operation methods, preoperative neurologic deficit, repeat surgery approach, number of fusion segments were analyzed as factors affecting the outcome.Results:2 patients who didn’t undergo the surgical management are still suffering from the lumber or leg pain, and are independent, but their life qualities are not improved.24 patients who underwent surgical management have significant improvement. JOA and VAS scores at final follow-up as compared to preoperative JOA and VAS scores, respectively, the differences being statistically significant (p<0.001); At final follow-up,19 patients (79.2%) were satisfied from the management. Patients with preoperative neurologic deficit and underwent ETD had poor clinical outcome, and the differences were statistical significant(p<0.05)。Conclusions:Surgical management for the treatment of recurrent lumbar disc herniation is relatively effective, and preoperative neurologic deficit, repeat surgery approach may affect the clinical outcome of the surgery.