Early Recurrence of Lumbar Disc Herniation: A Retrospective Analysis of the Role of Discectomy Volume and Other Influencing Factors
Öz
Objective:
The aim of this study is to conduct a detailed examination of cases of "Early Recurrence" encountered following lumbar disc herniation, and to compare the data obtained with findings in the existing literature.
Materials and Methods:
This retrospective study was conducted by analyzing the data of 856 patients who were operated for recurrent lumbar hernia in our hospital between 2012 and 2022. By expanding the definition of "early relapse" in the literature, inclusion and exclusion criteria were determined, and as a result, 43 patients who met the criteria were included in the study
Results:
The severity of symptoms was assessed based on patients' Visual Analog Scale (VAS) scores at baseline and during subsequent periods. Patients requiring reoperation within the first 12 months were divided into two main groups: those undergoing reoperation within the first 6 months and those undergoing reoperation between 6-12 months. However, no statistically significant difference was found between the two groups in terms of age, gender, comorbidities, and other determinants. Notably, patients undergoing surgery within the first 3 months were observed to be of advanced age.
Conclusion:
When comparing the data obtained from analyzing patients with "early recurrent lumbar disc herniation" with findings shared in the literature, we found that similar variables were not significant in our series. An interesting observation is that both full endoscopic and microscopic methods have similar early recurrence rates. This is particularly noteworthy because full endoscopic discectomy usually involves sequestrectomy, and the volume of the disk removed is typically minimal. Hence, our study suggests that the volume of the disk removed during surgery may not be as influential in the development of early recurrence as previously thought. These findings provide an important foundation for future research.
Anahtar Kelimeler
lumbar discectomy recurrence early recurrence microscopic discectomy
Kaynakça
- 1. Pan M, Li O, Li S, et al. Percutaneous endoscopic lumbar discectomy: Indications and complications. Pain Physician. 2020; 23:49-56.
- 2. Yin S, Du H, Yang W, Duan C, Feng C, Tao H. Prevalence of recurrent herniation following percutaneous endoscopic lumbar discectomy: A meta-analysis. Pain Physician. 2018; 21:337-50.
- 3. Park CH, Park ES, Lee SH, et al. Risk factors for early recurrence after transforaminal endoscopic lumbar disc decompression. Pain Physician. 2019; 22:133-38.
- 4. Yaman ME, Kazancı A, Yaman ND, Baş F, Ayberk G. Factors that influence recurrent lumbar disc herniation. Hong Kong Med J. 2017; 23:258-63.
- 5. Li Z, Yang H, Liu M, et al. Clinical characteristics and risk factors of recurrent lumbar disk herniation: A retrospective analysis of three hundred twenty-one cases. Spine (Phila Pa 1976). 2018; 43:1463-69.
- 6. Swartz KR, Trost GR: Recurrent lumbar disc herniation. Neurosurg Focus. 2003;15: 3-10.
- 7. Carragee EJ, Han MY, Suen PW, Kim D: Clinical outcomes after lumbar discectomy for sciatica: The effects of fragment type and anular competence. J Bone Joint Surg Am. 2003;85(1):102-108.
- 8. Jönsson B, Strömqvist B: Clinical characteristics of recurrent sciatica after lumbar discectomy. Spine (Phila Pa 1976). 1996; 21(4):500-505.
- 9. Zdeblick TA: The treatment of degenerative lumbar disorders: A critical review of the literature. Spine (Phila Pa 1976). 1995; 20:126-37.
- 10. An HS, Nguyen C, Haughton VM, Ho KC, Hasegawa T: Gadoliniumenhancement characteristics of magnetic resonance imaging in distinguishing herniated intervertebral disc versus scar in dogs. Spine (Phila Pa 1976). 1994; 19(18):2089-94.
- 11. Babar S, Saifuddin A: MRI of the postdiscectomy lumbar spine. Clin Radiol. 2002;57: 969-81.
- 12. Kong M, Xu D, Gao C, et al. Risk factors for recurrent L4-5 disc herniation after percutaneous endoscopic transforaminal discectomy: A retrospective analysis of 654 Cases. Risk Manag Healthc Policy. 2020; 13:3051-65.
- 13. Kim JM, Lee SH, Ahn Y, Yoon DH, Lee CD, Lim ST. Recurrence after successful percutaneous endoscopic lumbar discectomy. Minim Invasive Neurosurg. 2007; 50:82-85.
- 14. Guo J, Li G, Ji X, et al. Clinical and Radiological Risk Factors of Early Recurrent Lumbar Disc Herniation at Six Months or Less: A Clinical Retrospective Analysis in One Medical Center. Pain Physician. 2022; 25:1039-45.
- 15. Yao Y, Liu H, Zhang H, et al. Risk Factors for the Recurrent Herniation After Microendoscopic Discectomy. World Neurosurg. 2016; 95:451-55.
- 16. Boden SD, McCowin PR, Davis DO, Dina TS, Mark AS, Wiesel S. Abnormal magnetic-resonance scans of the cervical spine in asymptomatic subjects: A prospective investigation. J Bone Joint Surg Am. 1990; 72:1178-84
Öz
Kaynakça
- 1. Pan M, Li O, Li S, et al. Percutaneous endoscopic lumbar discectomy: Indications and complications. Pain Physician. 2020; 23:49-56.
- 2. Yin S, Du H, Yang W, Duan C, Feng C, Tao H. Prevalence of recurrent herniation following percutaneous endoscopic lumbar discectomy: A meta-analysis. Pain Physician. 2018; 21:337-50.
- 3. Park CH, Park ES, Lee SH, et al. Risk factors for early recurrence after transforaminal endoscopic lumbar disc decompression. Pain Physician. 2019; 22:133-38.
- 4. Yaman ME, Kazancı A, Yaman ND, Baş F, Ayberk G. Factors that influence recurrent lumbar disc herniation. Hong Kong Med J. 2017; 23:258-63.
- 5. Li Z, Yang H, Liu M, et al. Clinical characteristics and risk factors of recurrent lumbar disk herniation: A retrospective analysis of three hundred twenty-one cases. Spine (Phila Pa 1976). 2018; 43:1463-69.
- 6. Swartz KR, Trost GR: Recurrent lumbar disc herniation. Neurosurg Focus. 2003;15: 3-10.
- 7. Carragee EJ, Han MY, Suen PW, Kim D: Clinical outcomes after lumbar discectomy for sciatica: The effects of fragment type and anular competence. J Bone Joint Surg Am. 2003;85(1):102-108.
- 8. Jönsson B, Strömqvist B: Clinical characteristics of recurrent sciatica after lumbar discectomy. Spine (Phila Pa 1976). 1996; 21(4):500-505.
- 9. Zdeblick TA: The treatment of degenerative lumbar disorders: A critical review of the literature. Spine (Phila Pa 1976). 1995; 20:126-37.
- 10. An HS, Nguyen C, Haughton VM, Ho KC, Hasegawa T: Gadoliniumenhancement characteristics of magnetic resonance imaging in distinguishing herniated intervertebral disc versus scar in dogs. Spine (Phila Pa 1976). 1994; 19(18):2089-94.
- 11. Babar S, Saifuddin A: MRI of the postdiscectomy lumbar spine. Clin Radiol. 2002;57: 969-81.
- 12. Kong M, Xu D, Gao C, et al. Risk factors for recurrent L4-5 disc herniation after percutaneous endoscopic transforaminal discectomy: A retrospective analysis of 654 Cases. Risk Manag Healthc Policy. 2020; 13:3051-65.
- 13. Kim JM, Lee SH, Ahn Y, Yoon DH, Lee CD, Lim ST. Recurrence after successful percutaneous endoscopic lumbar discectomy. Minim Invasive Neurosurg. 2007; 50:82-85.
- 14. Guo J, Li G, Ji X, et al. Clinical and Radiological Risk Factors of Early Recurrent Lumbar Disc Herniation at Six Months or Less: A Clinical Retrospective Analysis in One Medical Center. Pain Physician. 2022; 25:1039-45.
- 15. Yao Y, Liu H, Zhang H, et al. Risk Factors for the Recurrent Herniation After Microendoscopic Discectomy. World Neurosurg. 2016; 95:451-55.
- 16. Boden SD, McCowin PR, Davis DO, Dina TS, Mark AS, Wiesel S. Abnormal magnetic-resonance scans of the cervical spine in asymptomatic subjects: A prospective investigation. J Bone Joint Surg Am. 1990; 72:1178-84
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri (Diğer) |
| Bölüm | Research Articles |
| Yazarlar | |
| Yayımlanma Tarihi | 20 Ekim 2023 |
| Gönderilme Tarihi | 7 Eylül 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 4 Sayı: Supplemental Issue |
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