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Long-term outcome of redo discectomy for recurrent lumbar disc herniations

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Abstract

Purpose

Recurrent lumbar disc herniation (RLDH) is an important cause of morbidity and healthcare costs. The goal of this investigation is to assess surgical outcomes and their predictors in patients who underwent revision discectomy for RLDH, with a minimum follow-up of ten years, to shed light on the best treatment to offer to these patients.

Methods

Patients who underwent revision discectomy to treat RLDH between 2004 and 2011 in our Department were enrolled. Demographic, clinical, and surgical data were collected. The need of third intervention for RLDH was the primary outcome. Patient’s satisfaction, Core Outcome Measures Index, Oswestry Disability Index, and EuroQoL-5D scores were also evaluated.

Results

This study includes 55 patients, with a mean follow-up time of 144 months [112–199]. In this period, a third intervention was needed in 30.9% (n = 17) of patients. Most recurrences took place in the first 2 years after the second surgery (58.8%, n = 10) and the risk of needing a third surgery decreased over time. After 5 years, the probability of not having surgery for recurrence was 71% [CI 95%: 60–84%], with a tendency to stabilize after that. An interval between the first discectomy and the surgery for recurrence shorter than 7.6 months was identified as a predictor for a second recurrence.

Conclusion

The risk of needing a third surgery seems to stabilize after five years. Patients with an early recurrence after the first discectomy seem to have a higher risk of a new recurrence, so an arthrodesis might be worth considering.

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Availability of data and materials

The datasets analysed and generated during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Acknowledgements

We thank Dr. Natália Barbosa for help with data collecting.

Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Neurosurgery Department, Centro Hospitalar Universitário São João, Porto, Portugal

    M. Cunha, P. S. Silva, R. Vaz & P. Pereira

  2. Faculdade de Medicina da Universidade Do Porto, Porto, Portugal

    M. Cunha, D. Basto, P. S. Silva, R. Vaz & P. Pereira

Authors
  1. M. Cunha
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  2. D. Basto
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  3. P. S. Silva
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  4. R. Vaz
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  5. P. Pereira
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Correspondence to M. Cunha.

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Conflict of interest

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Ethical approval

This study was performed in accordance with the principles of the Declaration of Helsinki. The questionnaire and methodology for this study were approved by the ethical committee of Centro Hospitalar Universitário de São João.

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Informed consent was obtained from participants included in the study.

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Cunha, M., Basto, D., Silva, P.S. et al. Long-term outcome of redo discectomy for recurrent lumbar disc herniations. Eur Spine J 32, 534–541 (2023). https://doi.org/10.1007/s00586-022-07493-4

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  • DOI: https://doi.org/10.1007/s00586-022-07493-4

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