Clinical Outcomes Of Posterior Lumber Interbody Fusion For Recurrent Lumber Disc Herniation After Discectomy

OBJECTIVES To compare clinical outcomes of recurrent lumbar disc herniation after posterior lumbar interbody fusion.METHODS56 patients with recurrent lumbar disc herniation received PLIF from January 2007 to June 2012 in Shanghai Sixth People's Hospital. They were divided into three groups according to symptoms: Lumbocrural Pain Type(LPT);Lower Extremity Numbness accompanied by Sciatica Type(LENST); Lumbocrural Pain accompanied by Lower Extremity Numbness Type(LPLEN). Analysis of clinical outcomes among three groups was made according to the Japanese Orthopaedic Association Scores(JOA Scores), Visual Analogue Scale(VAS),Mac Nab scores and The Oswestry Disability Index(ODI) recorded during the long-term follow-up period(3rd month, 6th month, 12 th month, 24 th month).RESULTS The postoperative JOA scores estimated at each time point in the three groups were significantly higher than the JOA scores estimated before surgery.Clinical outcomes of the 24 th month revealed that JOA scores in LPT group were better than those in LENST and LPLEN groups(P<0.05), along with higher scores of LPLEN group compared to LENST group(P<0.05). The postoperative VAS scores of lumbocrural pain estimated at each time point of the three groups significantly decreased(P<0.05), except the VAS scores of back pain in LENST group. The postoperative VAS scores for back pain in the LENST group were remarkably higher than those before PLIF at the 3rd month(P<0.05).The VAS scores of back pain estimated at the 12 th month and 24 th month decreased(P<0.05). According to Mac Nab scores, the satisfaction rate of LPL group is100%; LENST group is 88.89%, LPLEN group is 93.10%. The postoperative ODI estimated at 24 th month in the three groups were significantly lower than the ODI estimated before surgery.CONCLUSIONS PLIF can play perfect clinical outcomes in patients of Lumbocrural Pain Type and Lumbocrural Pain accompanied by Lower Extremity Numbness Type. The clinical results of Lower Extremity Numbness accompanied by Sciatica Type are not as good as previous ones.