Recurrent Lumbar Disc Herniation: Results of Revision Surgery and Assessment of Factors that May Affect the Outcome. A Non-Concurrent Prospective Study
Study DesignNon-concurrent prospective study.PurposeTo determine the functional outcome after open 'fragment' discectomy for recurrent lumbar disc herniation, and to analyze the factors that may affect the outcome.Overview of LiteratureLiterature search revealed only four studies where the...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Korean Spine Society
2015-10-01
|
Series: | Asian Spine Journal |
Subjects: | |
Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-9-728.pdf |
id |
doaj-6975002c267442ffb37b11b1554537f5 |
---|---|
record_format |
Article |
spelling |
doaj-6975002c267442ffb37b11b1554537f52020-11-24T23:59:40ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462015-10-019572873610.4184/asj.2015.9.5.728834Recurrent Lumbar Disc Herniation: Results of Revision Surgery and Assessment of Factors that May Affect the Outcome. A Non-Concurrent Prospective StudyMohammed Ibrahim0Justin Arockiaraj1Rohit Amritanand2Krishnan Venkatesh3Kenny Samuel David4Department of Orthopaedics, Spinal Disorders Surgery Unit, Christian Medical College, Vellore, India.Department of Orthopaedics, Spinal Disorders Surgery Unit, Christian Medical College, Vellore, India.Department of Orthopaedics, Spinal Disorders Surgery Unit, Christian Medical College, Vellore, India.Department of Orthopaedics, Spinal Disorders Surgery Unit, Christian Medical College, Vellore, India.Department of Orthopaedics, Spinal Disorders Surgery Unit, Christian Medical College, Vellore, India.Study DesignNon-concurrent prospective study.PurposeTo determine the functional outcome after open 'fragment' discectomy for recurrent lumbar disc herniation, and to analyze the factors that may affect the outcome.Overview of LiteratureLiterature search revealed only four studies where the factors affecting the outcome of a revision surgery for recurrent disc herniation have been evaluated. None of these studies analyzed for diabetes, disc degeneration and facet arthropathy. We have analyzed these features, in addition to the demographic and clinical factors.MethodsThirty-four patients who underwent the procedure were followed up for an average period of 27.1 months. The Japanese Orthopaedic Association (JOA) score and Oswestry disability index (ODI) were used to assess the functional outcome. Age, gender, smoking, diabetic status, duration of recurrent symptoms, the side of leg pain, level and type of disc herniation, degree of disc degeneration on magnetic resonance imaging, and facet joint arthritis before first and second surgeries, were analyzed as factors affecting the outcome.ResultsThe average Hirabayashi improvement in JOA was 56.4%. The mean preoperative ODI was 74.5% and the mean ODI at final follow-up was 32.2%, the difference being statistically significant (p<0.01). Patients with diabetes, all of whom had poor long term glycemic control, were found to have a poor outcome in terms of ODI improvement (p=0.03).ConclusionsOpen fragment discectomy is a safe and effective surgical technique for the treatment of recurrent disc herniation. However, patients with uncontrolled diabetes may have a less favorable outcome.http://www.asianspinejournal.org/upload/pdf/asj-9-728.pdfRadiculopathyRecurrent low back painDiabetes mellitusDiscectomyOutcome assessment |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mohammed Ibrahim Justin Arockiaraj Rohit Amritanand Krishnan Venkatesh Kenny Samuel David |
spellingShingle |
Mohammed Ibrahim Justin Arockiaraj Rohit Amritanand Krishnan Venkatesh Kenny Samuel David Recurrent Lumbar Disc Herniation: Results of Revision Surgery and Assessment of Factors that May Affect the Outcome. A Non-Concurrent Prospective Study Asian Spine Journal Radiculopathy Recurrent low back pain Diabetes mellitus Discectomy Outcome assessment |
author_facet |
Mohammed Ibrahim Justin Arockiaraj Rohit Amritanand Krishnan Venkatesh Kenny Samuel David |
author_sort |
Mohammed Ibrahim |
title |
Recurrent Lumbar Disc Herniation: Results of Revision Surgery and Assessment of Factors that May Affect the Outcome. A Non-Concurrent Prospective Study |
title_short |
Recurrent Lumbar Disc Herniation: Results of Revision Surgery and Assessment of Factors that May Affect the Outcome. A Non-Concurrent Prospective Study |
title_full |
Recurrent Lumbar Disc Herniation: Results of Revision Surgery and Assessment of Factors that May Affect the Outcome. A Non-Concurrent Prospective Study |
title_fullStr |
Recurrent Lumbar Disc Herniation: Results of Revision Surgery and Assessment of Factors that May Affect the Outcome. A Non-Concurrent Prospective Study |
title_full_unstemmed |
Recurrent Lumbar Disc Herniation: Results of Revision Surgery and Assessment of Factors that May Affect the Outcome. A Non-Concurrent Prospective Study |
title_sort |
recurrent lumbar disc herniation: results of revision surgery and assessment of factors that may affect the outcome. a non-concurrent prospective study |
publisher |
Korean Spine Society |
series |
Asian Spine Journal |
issn |
1976-1902 1976-7846 |
publishDate |
2015-10-01 |
description |
Study DesignNon-concurrent prospective study.PurposeTo determine the functional outcome after open 'fragment' discectomy for recurrent lumbar disc herniation, and to analyze the factors that may affect the outcome.Overview of LiteratureLiterature search revealed only four studies where the factors affecting the outcome of a revision surgery for recurrent disc herniation have been evaluated. None of these studies analyzed for diabetes, disc degeneration and facet arthropathy. We have analyzed these features, in addition to the demographic and clinical factors.MethodsThirty-four patients who underwent the procedure were followed up for an average period of 27.1 months. The Japanese Orthopaedic Association (JOA) score and Oswestry disability index (ODI) were used to assess the functional outcome. Age, gender, smoking, diabetic status, duration of recurrent symptoms, the side of leg pain, level and type of disc herniation, degree of disc degeneration on magnetic resonance imaging, and facet joint arthritis before first and second surgeries, were analyzed as factors affecting the outcome.ResultsThe average Hirabayashi improvement in JOA was 56.4%. The mean preoperative ODI was 74.5% and the mean ODI at final follow-up was 32.2%, the difference being statistically significant (p<0.01). Patients with diabetes, all of whom had poor long term glycemic control, were found to have a poor outcome in terms of ODI improvement (p=0.03).ConclusionsOpen fragment discectomy is a safe and effective surgical technique for the treatment of recurrent disc herniation. However, patients with uncontrolled diabetes may have a less favorable outcome. |
topic |
Radiculopathy Recurrent low back pain Diabetes mellitus Discectomy Outcome assessment |
url |
http://www.asianspinejournal.org/upload/pdf/asj-9-728.pdf |
work_keys_str_mv |
AT mohammedibrahim recurrentlumbardischerniationresultsofrevisionsurgeryandassessmentoffactorsthatmayaffecttheoutcomeanonconcurrentprospectivestudy AT justinarockiaraj recurrentlumbardischerniationresultsofrevisionsurgeryandassessmentoffactorsthatmayaffecttheoutcomeanonconcurrentprospectivestudy AT rohitamritanand recurrentlumbardischerniationresultsofrevisionsurgeryandassessmentoffactorsthatmayaffecttheoutcomeanonconcurrentprospectivestudy AT krishnanvenkatesh recurrentlumbardischerniationresultsofrevisionsurgeryandassessmentoffactorsthatmayaffecttheoutcomeanonconcurrentprospectivestudy AT kennysamueldavid recurrentlumbardischerniationresultsofrevisionsurgeryandassessmentoffactorsthatmayaffecttheoutcomeanonconcurrentprospectivestudy |
_version_ |
1725446823518142464 |