CORR Insights^®: Recurrent Versus Primary Lumbar Disc Herniation Surgery: Patient-reported Outcomes in the Swedish Spine Register Swespine

Excerpt

Recent large, prospective studies [1, 5] have supported acceptable, cost-effective, validated patient reported clinical outcomes for discectomy under direct visualization for the treatment of primary lumbar disc herniation. Recurrent disc herniation is infrequent, but when it occurs, it is an important driver of costs. Prior studies [2] have suggested acceptable clinical results with redo discectomy for recurrent herniation. However, these studies have tended to be case reports with small numbers of patients and inconsistent use of validated outcome measures. The current registry study suggests reasonable short-term clinical results using validated outcome measures in patients undergoing reoperation for a presumed diagnosis of “recurrent disc herniation” after prior discectomy. From a registry, it is difficult to determine whether the patients undergoing repeat surgery truly had a recurrent disc herniation, or ongoing/recurrent sciatic symptoms after discectomy surgery with subsequent imaging studies showing disc pathology that triggered further surgery. This is an important distinction in terms of identifying who might benefit from the index and the additional surgery. …