Year : 2018 | Volume
: 9 | Issue : 4 | Page : 260--266
Recurrent lumbar disc herniation: Is there a correlation with the surgical technique? A multivariate analysis
Alessandro Landi1, Giovanni Grasso2, Cristina Mancarella1, Demo Eugenio Dugoni1, Fabrizio Gregori1, Giorgia Iacopino1, Harrison Xiao Bai3, Nicola Marotta1, Andrea Iaquinandi1, Roberto Delfini1
1 Department of Neurology and Psychiatry, Division of Neurosurgery, “Sapienza” University of Rome, Rome, Italy
2 Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy
3 Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Purpose: The recurrence of a lumbar disc herniation (LDH) is a common cause of poor outcome following lumbar discectomy. The aim of this study was to assess a potential relationship between the incidence of recurrent LDH and the surgical technique used. Furthermore, we tried to define the best surgical technique for the treatment of recurrent LDH to limit subsequent recurrences.
Materials and Methods: A retrospective study was conducted on 979 consecutive patients treated for LDH. A multivariate analysis tried to identify a possible correlation between (1) the surgical technique used to treat the primary LDH and its recurrence; (2) technique used to treat the recurrence of LDH and the second recurrence; and (3) incidence of recurrence and clinical outcome. Data were analyzed with the Pearson's Chi-square test for its significance.
Results: In 582 cases (59.4%), a discectomy was performed, while in 381 (40.6%), a herniectomy was undertaken. In 16 cases, a procedure marked as “other” was performed. Among all patients, 110 (11.2%) had a recurrence. Recurrent LDH was observed in 55 patients following discectomy (9.45%), in 45 following herniectomy (11.8%), and in 10 (62.5%) following other surgery. Our data showed that 90.5% of discectomies and 88.2% of the herniectomies had a good clinical outcome, whereas other surgeries presented a recurrence rate of 62.5% (Pearson's χ2 < 0.001). No statistical differences were observed between discectomy or herniectomy, for the treatment of the recurrence, and the incidence for the second recurrences (P > 0.05). A significant statistical correlation emerged between the use of other techniques and the incidence for the second recurrences (P < 0.05).
Conclusions: The recurrence of an LDH is one of the most feared complications following surgery. Although the standard discectomy has been considered more protective toward the recurrence compared to herniectomy, our data suggest that there is no significant correlation between the surgical technique and the risk of LDH recurrence.
Prof. Giovanni Grasso
Department of Experimental Biomedicine and Clinical Neurosciences, Policlinico Universitario Di Palermo, Via Del Vespro 129, 90100 Palermo
|How to cite this article:|
Landi A, Grasso G, Mancarella C, Dugoni DE, Gregori F, Iacopino G, Bai HX, Marotta N, Iaquinandi A, Delfini R. Recurrent lumbar disc herniation: Is there a correlation with the surgical technique? A multivariate analysis.J Craniovert Jun Spine 2018;9:260-266
|How to cite this URL:|
Landi A, Grasso G, Mancarella C, Dugoni DE, Gregori F, Iacopino G, Bai HX, Marotta N, Iaquinandi A, Delfini R. Recurrent lumbar disc herniation: Is there a correlation with the surgical technique? A multivariate analysis. J Craniovert Jun Spine [serial online] 2018 [cited 2019 Aug 19 ];9:260-266
Available from: http://www.jcvjs.com/article.asp?issn=0974-8237;year=2018;volume=9;issue=4;spage=260;epage=266;aulast=Landi;type=0