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http://dx.doi.org/10.3340/jkns.2008.44.5.320

Contralateral Reherniation after Open Lumbar Microdiscectomy : A Comparison with Ipsilateral Reherniation  

Choi, Kyeong-Bo (Department of Neurosurgery, Wooridul Spine Hospital)
Lee, Dong-Yeob (Department of Neurosurgery, Wooridul Spine Hospital)
Lee, Sang-Ho (Department of Neurosurgery, Wooridul Spine Hospital)
Publication Information
Journal of Korean Neurosurgical Society / v.44, no.5, 2008 , pp. 320-326 More about this Journal
Abstract
Objective : To evaluate the risk factors that may be responsible for the development of contralateral reherniations from ipsilateral ones after open lumbar microdiscectomy (OLM), and to compare surgical outcomes of revision OLM for contralateral reherniations with those for ipsilateral ones. Methods: Seventeen patients who underwent revision OLM for contralateral reherniation were enrolled into Group I, and 35 patients who underwent revision OLM for ipsilateral reherniation were enrolled into Group II. Using medical charts and imaging study results, the differences in the clinical and radiological factors were evaluated between the two groups. Clinical outcomes of each group were compared between the two groups. Results: Significant differences were found in the interval to reherniation from initial surgery (33 months for Group I and 18.6 months for Group II, p=0.009), as well as in the incidences of both protruded disc (35.3% for Group I and 8.6% for Group II, p=0.045) and mild disc degeneration (29.4% for Group I and 5.7% for Group II, p=0.031) at initial surgery. On binary multi-logistic regression analysis, significant differences were found in the interval to reherniation (p=0.027, Odds ratio=1.051) and incidence of mild disc degeneration (p=0.025, Odds ratio= 12.03) between the two groups. There were no significant differences in the improvement of clinical outcomes after revision OLM between the two groups. Conclusion: The interval to reherniation from initial surgery and the grade of disc degeneration at initial surgery were key factors that distinguished the development of contralateral reherniations from ipsilateral ones. Surgical outcomes of revision OLM were similar in both groups.
Keywords
Reherniation; Discectomy; Lumbar spine;
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1 Epstein JA, Lavine LS, Epstein BS : Recurrent herniation of the lumbar intervertebral disk. Clin Orthop Relat Res 52 : 169-178, 1967   DOI
2 Shim CS, Lee SH, Shin HD, Kang HS, Choi WC, Jung B, et al : CHARITE versus ProDisc : a comparative study of a minimum 3- year follow-up. Spine 32 : 1012-1018, 2007   DOI   ScienceOn
3 Erbayraktar S, Acar F, Tekinsoy B, Acar U, Güner EM : Outcome analysis of reoperations after lumbar discectomies : a report of 22 patients. Kobe J Med Sci 48 : 33-41, 2002   PUBMED
4 Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N : Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine 26 : 1873-1878, 2001   DOI   ScienceOn
5 Herron L : Recurrent lumbar disc herniation : results of repeat laminectomy and discectomy. J Spinal Disord 7 : 161-166, 1994   DOI   ScienceOn
6 Ozgen S, Naderi S, Ozek MM, Pamir MN : Findings and outcome of revision lumbar disc surgery. J Spinal Disord 12 : 287-292, 1999   PUBMED
7 Papadopoulos EC, Girardi FP, Sandhu HS, Sama AA, Parvataneni HK, O'Leary PF, et al : Outcome of revision discectomies following recurrent lumbar disc herniation. Spine 31 : 1473-1476, 2006   DOI   ScienceOn
8 Spengler DM : Lumbar discectomy : results of a limited disc excision and selective foraminotomy. Spine 7 : 604-607, 1982   DOI
9 Torma T : Post-operative recurrence of lumbar disc herniation. Acta Chir Scand 103 : 213-221, 1952   PUBMED
10 Dora C, Schmid MR, Elfering A, Zanetti M, Hodler J, Boos N : Lumbar disk herniations : do MR imaging findings predict recurrence after surgical diskectomy? Radiology 235 : 562-567, 2005   DOI   ScienceOn
11 Masaryk TJ, Ross JS, Modic MT, Boumphrey F, Bohlman H, Wilber G : High resolution MR imaging of sequestrated lumbar intervertebral disks. Am J Roentgenol 150 : 1155-1162, 1988   DOI   PUBMED   ScienceOn
12 Carragee EJ, Han MY, Suen PW, Kim D : Clinical outcomes after lumbar discectomy for sciatica : the effects of fragment type and annular competence. J Bone Joint Surg Am 85 : 102-108, 2003   DOI   PUBMED
13 Ebeling U, Kalbarcyk H, Reulen HJ : Microsurgical reoperation following lumbar disc surgery : timing, surgical findings, and outcome in 92 patients. J Neurosurg 70 : 397-404, 1989   DOI
14 Le H, Sandhu FA, Fessler RG : Clinical outcomes after minimalaccess surgery for recurrent lumbar disc herniation. Neurosurg Focus 15 : E12, 2003
15 Modic MT, Steinberg PM, Ross JS, Masaryk TJ, Carter JR : Degenerative disk disease : assessment of changes in vertebral body marrow with MR imaging. Radiology 166 : 193-199, 1988   DOI   PUBMED
16 Lee SH, Chung SE, Ahn Y, Kim TH, Park JY, Shin SW : Comparative radiologic evaluation of percutaneous endoscopic lumbar discectomy and open microdiscectomy. Mt Sinai J Med 73 : 795- 801, 2006   PUBMED
17 Suk KS, Lee HM, Moon SH, Kim NH : Recurrent lumbar disc herniation : results of operative management. Spine 26 : 672-676, 2001   DOI   ScienceOn
18 Yorimitsu E, Chiba K, Toyama Y, Hirabayashi K : Long-term outcomes of standard discectomy for lumbar disc herniation : a follow-up study of more than 10 years. Spine 26 : 652-657, 2001   DOI   ScienceOn
19 Fairbank JC, Couper J, Davies JB, O'Brien JP : The Oswestry low back pain disability questionnaire. Physiotherapy 66 : 271-273, 1980   PUBMED
20 Cinotti G, Roysam GS, Eisenstein SM, Postacchini F : Ipsilateral recurrent lumbar disc herniation. A prospective, controlled study. J Bone Joint Surg Br 80 : 825-832, 1998   DOI
21 Tsai CH, Hsu HC, Chen YJ, Lin CJ, Chen HT : Recurrent lumbar disc herniation after discectomy : clinical result of repeated discectomy and analysis of factors affecting surgical outcome. Mid Taiwan J Med 12 : 125-132, 2007
22 Mochida J, Nishimura K, Nomura T : Appropriate procedure of posterior herniotomy and percutaneous nucleotomy in lumbar disc herniation. Rinsho Seikei Geka 29 : 423-430, 1994
23 O'Sullivan MG, Connolly AF, Buckley TF : Recurrent lumbar disc protrusion. Br J Neurosurg 4 : 319-326, 1990   DOI
24 Dai LY, Zhou Q, Yao WF, Shen L : Recurrent lumbar disc herniation after discectomy : outcome of repeat discectomy. Surg Neurol 64 : 226-231; discussion 231, 2005   DOI   ScienceOn
25 Swartz KR, Trost GR : Recurrent lumbar disc herniation. Neurosurg Focus 15 : E10, 2003
26 Carreon LY, Puno RM, Dimar JR 2nd, Glassman SD, Johnson JR : Perioperative complications of posterior lumbar decompression and arthrodesis in older adults. J Bone Joint Surg Am 85 : 2089-2092, 2003   DOI   PUBMED
27 Cinotti G, Gumina S, Giannicola G, Postacchini F : Contralateral recurrent lumbar disc herniation : results of discectomy compared with those in primary herniation. Spine 24 : 800-806, 1999   DOI   ScienceOn
28 Jacchia GE, Bardelli M, Barile L, D'arienzo M, Innocenti M : Casistica, risultati e cause di insuccessi di ernie discali operate. Ital J Orthop Traumatol 6 : 5-23, 1980   PUBMED
29 Silvers HR, Lewis PJ, Asch HL, Clabeaux DE : Lumbar diskectomy for recurrent disk herniation. J Spinal Disord 7 : 408-419, 1994   PUBMED