The risk factors in patients undergoing surgery for recurrent lumbar herniated disc

Abstract

Purpose: Herniated lumbar disc is the herniation of the nucleousus pulposus through a tear in the annulus fibrosis of the lumbar intervertebral discs. Recurrent disc herniation is the herniation of the nucleosus pulposus in the same level contralateral or ipsilateral of an operated disc with at least 6 months of reduced symptoms. It is reported that recurrency after disc herniation is seen 5-15% in different series. In our study, we retrospectively compared the preoperative radiological findings of the patients who undergone operation for the first time for herniated disc with the preoperative radiological findings for their recurrency operation.

Methods: In our study, we retrospectively evaluated the changes in the first preoperative and second preoperative radiological examinations (lumbar direct radiographs and lumbar MRI) in terms of pathophysiology in 50 patients who were operated for the second time with the diagnosis of recurrent lumbar disc herniation.

Results: Radiological findings of the 50 patients included in the study are compared. It is found that male patients with old age, wide protusion and high disc degeneration and facet joint degeneration have a higher risk of recurrency.

Conclusion: Recurrent disc herniation is a serious problem that puts the patients and surgeons against each other. Using preoperative findings, the patients can be informed about their risk of recurrency before the operation, therefore the management of the recurrency can be more positive.