Top

European Spine Journal

Published in:

01-05-2016 | Original Article

Risk factors for the need of surgical treatment of a first recurrent lumbar disc herniation

Authors: Ratko Yurac, Juan J. Zamorano, Fernando Lira, Diego Valiente, Vicente Ballesteros, Alejandro Urzúa

Published in: European Spine Journal | Issue 5/2016

Abstract

Purpose

A recurrent lumbar disc herniation (RLDH) is the most prevalent cause for new radicular pain after surgery for disc herniation-induced sciatica. Reported risk factors include age, gender and smoking, while its surgical treatment is associated to a higher rate of complications and costs. The purpose of this study is to identify factors that increase the risk of requiring surgical treatment for a first RLDH in workers’ compensation patients.

Methods

Nested case–control: 109 patients operated for an RLDH (cases) between June 1st 1994 and May 31st 2011 (minimum follow-up 1 year) and 109 randomly selected patients operated for a first disc herniation with no recurrence during the study period (controls). Age, gender, smoking status, type of work and MRI characteristics of the index herniation were statistically evaluated as potential risk factors.

Results

Patient’s age of less than 35 years (p = 0.001) and a subligamentous herniation (p < 0.05) at the time of the index surgery were identified as risk factors for requiring surgical treatment of a first RLDH. No statistical differences were observed between both groups regarding the other evaluated variables.

Conclusion

A subligamentous disc herniation and patient’s age inferior to 35 years at the time of the first surgery are risk factors for requiring surgical treatment of a first RLDH among workers’ compensation patients.

Weinstein JN, Tosteson TD, Lurie JD et al (2006) Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT): a randomized trial. JAMA 296:2441–2450. doi:10.1001/jama.296.20.2441 CrossRefPubMedPubMedCentral

Graver V, Haaland AK, Magnaes B, Loeb M (1999) Seven-year clinical follow-up after lumbar disc surgery: results and predictors of outcome. Br J Neurosurg 13:178–184CrossRefPubMed

Loupasis GA, Stamos K, Katonis PG et al (1999) Seven-to 20-year outcome of lumbar discectomy. Spine 24:2313CrossRefPubMed

Yorimitsu E, Chiba K, Toyama Y, Hirabayashi K (2001) Long-term outcomes of standard discectomy for lumbar disc herniation: a follow-up study of more than 10 years. Spine 26:652–657CrossRefPubMed

McGirt MJ, Ambrossi GLG, Datoo G et al (2009) Recurrent disc herniation and long-term back pain after primary lumbar discectomy. Neurosurgery 64:338–345. doi:10.1227/01.NEU.0000337574.58662.E2 CrossRefPubMed

Kim K-T, Park S-W, Kim Y-B (2009) Disc height and segmental motion as risk factors for recurrent lumbar disc herniation. Spine 34:2674–2678CrossRefPubMed

Law JD, Lehman RA, Kirsch WM (1978) Reoperation after lumbar intervertebral disc surgery. J Neurosurg 48:259–263CrossRefPubMed

Papadopoulos EC, Girardi FP, Sandhu HS et al (2006) Outcome of revision discectomies following recurrent lumbar disc herniation. Spine 31:1473–1476CrossRefPubMed

Suk K-S, Lee HM, Moon SH, Kim N-H (2001) Recurrent lumbar disc herniation: results of operative management. Spine 26:672–676CrossRefPubMed

10.

Aizawa T, Ozawa H, Kusakabe T et al (2011) Reoperation for recurrent lumbar disc herniation: a study over a 20-year period in a Japanese population. J Orthop Sci 17:107–113. doi:10.1007/s00776-011-0184-6 CrossRefPubMed

11.

Jansson KÅ, Nemeth G, Granath F, Blomqvist P (2004) Surgery for herniation of a lumbar disc in Sweden between 1987 and 1999. J Bone Joint Surg Br 86:841–847. doi:10.1302/0301-620X.86B6 CrossRefPubMed

12.

McGirt MJ, Eustacchio S, Varga P et al (2009) A prospective cohort study of close interval computed tomography and magnetic resonance imaging after primary lumbar discectomy: factors associated with recurrent disc herniation and disc height loss. Spine 34:2044–2051CrossRefPubMed

13.

Lebow RL, Adogwa O, Parker SL et al (2011) Asymptomatic same-site recurrent disc herniation after lumbar discectomy. Spine 36:2147–2151. doi:10.1097/BRS.0b013e3182054595 CrossRefPubMed

14.

Cinotti G, Roysam GS, Eisenstein SM, Postacchini F (1998) Ipsilateral recurrent lumbar disc herniation. J Bone Joint Surg Br 80:825–832CrossRefPubMed

15.

Carragee EJ, Han MY, Suen PW, Kim D (2003) Clinical outcomes after lumbar discectomy for sciatica: the effects of fragment type and anular competence. J Bone Joint Surg Am 85:102–108PubMed

16.

Kim JM, Lee SH, Ahn Y et al (2007) Recurrence after successful percutaneous endoscopic lumbar discectomy. Minim Invasive Neurosurg 50:82–85. doi:10.1055/s-2007-982504 CrossRefPubMed

17.

Miwa S, Yokogawa A, Kobayashi T et al (2012) Risk factors of recurrent lumbar disc herniation: a single center study and review of the literature. J Spinal Disord Tech 28:E265–E269. doi:10.1097/BSD.0b013e31828215b3 CrossRef

18.

Morgan-Hough C, Jones PW, Eisenstein SM (2003) Primary and revision lumbar discectomy. J Bone Joint Surg Br 85:871–874. doi:10.1302/0301-620X.85B6.13626 PubMed

19.

Stolke D, Sollmann WP, Seifert V (1989) Intra-and postoperative complications in lumbar disc surgery. Spine 14:56CrossRefPubMed

20.

Ambrossi GLG, McGirt MJ, Sciubba DM et al (2009) Recurrent lumbar disc herniation after single-level lumbar discectomy. Neurosurgery 65:574–578. doi:10.1227/01.NEU.0000350224.36213.F9 CrossRefPubMed

21.

Fardon DF, Milette PC (2001) Nomenclature and classification of lumbar disc pathology: recommendations of the combined task forces of the North American Spine Society, American Society of Spine Radiology, and American Society of Neuroradiology. Spine 26:E93–E113CrossRefPubMed

22.

Modic MT, Steinberg PM, Ross JS et al (1988) Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology 166:193–199CrossRefPubMed

23.

Battié MC, Videman T, Levälahti E et al (2008) Genetic and environmental effects on disc degeneration by phenotype and spinal level: a Multivariate Twin Study. Spine 33:2801–2808. doi:10.1097/BRS.0b013e31818043b7 CrossRefPubMed

Title: Risk factors for the need of surgical treatment of a first recurrent lumbar disc herniation
Authors: Ratko Yurac
Juan J. Zamorano
Fernando Lira
Diego Valiente
Vicente Ballesteros
Alejandro Urzúa
Publication date: 01-05-2016
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 5/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-015-4272-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Risk factors for the need of surgical treatment of a first recurrent lumbar disc herniation

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 5/2016

A diagnostic study in patients with sciatica establishing the importance of localization of worsening of pain during coughing, sneezing and straining to assess nerve root compression on MRI

Spinal metallosis: a systematic review

Adjacent segment degeneration and revision surgery after circumferential lumbar fusion: outcomes throughout 15 years of follow-up

Radiological analysis of upper lumbar disc herniation and spinopelvic sagittal alignment

Preemptive multimodal analgesia for postoperative pain management after lumbar fusion surgery: a randomized controlled trial

Adjacent segment degeneration after lumbar spinal fusion compared with motion-preservation procedures: a meta-analysis