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Primary microendoscopic discectomy demonstrates relatively low reoperation rate
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Among patients treated for lumbar disc herniation, primary microendoscopic discectomy was found to have a low reoperation rate; however, patients with adjacent segment degeneration and Pfirrmann grading for disc degeneration may be at a higher risk for reoperation, according to results of a recently published study.
Researchers retrospectively analyzed 952 patients who underwent microendoscopic discectomy for single-level lumbar disc herniation at a single institute between 2005 and 2010. The researchers assessed causes and clinical parameters, and multivariate logistic regression was used to evaluate possible risk factors.
Fifty-eight of the patients studied underwent reoperation, and 76 disc herniations were excised through revision diskectomy with or without interbody fusion. About 81.1% of patients who underwent reoperation experienced adjacent disc degeneration, according to the researchers. Overall reoperation rates were observed to increase gradually during the study period, from 1.56% at year 1 to 8.17% at nearly 10 years.
Researchers noted patients with adjacent segment degeneration and Pfirrmann grading for disc degeneration were at higher risk for reoperation primary microendoscopic discectomy (odds ratio [OR] = 2.448 and 1.510, respectively). Additionally, patients who underwent reoperation tended to be older and have a higher lumbar degeneration level with severe Modic changes compared with patients who did not undergo reoperation.
The researchers concluded surgeons should evaluate patients with adjacent segment degeneration and Pfirrmann grading for disc degeneration to qualify the chances of microendoscopic discectomy leading to a revision operation. – by Robert Linnehan
Disclosure: The researchers report no relevant financial disclosures.
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