Recurrent Lumbar Disc Herniation after Discectomy: Clinical Result of Repeated Discectomy and Analysis of Factors Affecting Surgical Outcome

Purpose. To identify the factors that may influence the outcome of repeated discectomy in patients with recurrent disc herniation. Methods. A series of 825 patients underwent surgery for lumbar disc herniation in our department from January 1995 to February 2005. A total of 33 consecutive patients who underwent repeated discectomy for recurrent lumbar disc herniations were retrospectively analyzed to assess factors affecting surgical outcome. Revision surgery was performed in all patients with conventional open discectomy. Visual analogue scale (VAS) and MacNab criteria were used to evaluate the severity of pain and satisfaction after revision surgery. The factors that might affect clinical outcome included gender, cigarette smoking, traumatic event, pain-free interval, side and degree of herniation and clinical improvement rate. Results. The incidence of recurrent lumbar disc herniation was about 4%. Satisfactory outcomes were noted in 27 patients (82%) according to the MacNab criteria, and 26 (79%) patients had no radicular pain based on the VAS scale. No single factor was found to be predictive of clinical outcomes of repeated discectomy. Conclusion. Repeated discectomy for recurrent lumbar disc herniation leads to a satisfactory outcome. Therefore, repeated open discectomy can be considered when managing patients with recurrent lumbar disc herniation.