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Recurrent lumbar disc herniation is common following open discectomy
Lee JK. J Am Acad Orthop Surg. 2010;18(6):327-337.
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According to literature review results, recurrent lumbar disc herniation is the most common complication after primary open discectomy.
The researchers, led by Joseph K. Lee, MD, New York-Presbyterian Hospital, defined recurrent back and/or leg pain as pain that returned after a pain-free period lasting 6 months from the initial surgery.
“When a patient has recurring pain, surgeons should perform a complete workup, including an MRI, to learn whether the cause is actually recurrent disc herniation or another problem, such as spinal instability,” co-author Mark Weidenbaum, MD, stated in an American Academy of Orthopaedic Surgeons press release. “If a patient has spinal instability a revision discectomy isn’t going to help that person — another type of surgery may be needed.”
According to the release, recurrent disc herniation occurs in approximately 5% to 15% of patients who undergo open discectomy.
Recurrent lumbar disc herniation treatment requires aggressive medical management and surgical intervention, according to the researchers. Surgical techniques include conventional open discectomy, minimally invasive open discectomy or open discectomy with fusion.
Fusion is necessary in patients with concomitant segmental instability or significant foraminal stenosis because of disc space collapse, the authors wrote.
The literature showed that patients with larger herniations were more likely to have a recurrence of pain, according to the release. In addition, there may be a link between technique and recurrence risk. Patients who underwent endoscopic surgery may be more likely to have a recurrence than those who had a more invasive procedure.