Recurrent Lumbar Disk Herniation With or Without Posterolateral Fusion

Study Design:A prospective study assessing the outcomes of repeat surgery for recurrent lumbar disc herniation. Objectives:To evaluate the results of repeat surgery for recurrent disc herniation, and compare the results of disc excision with and without posterolateral fusion. Methods:The study included 39 patients who underwent disc excision with or without posterolateral fusion, with an average follow-up of 66.7 months (range, 24-116 months). Clinical symptoms were assessed based on the Japanese Orthopedic Association Back Scores. Medical and surgical data were examined and analyzed, including pain-free interval, intraoperative blood loss, length of surgery, and postoperative hospital stay. Results:Clinical outcome was excellent or good in 84.6% of patients, including 83.3% of patients undergoing a discectomy alone, and 84.6% of patients with posterolateral fusion. The recovery rate was 84.4%, and the difference between the fusion and nonfusion groups was insignificant (P=0.725). The difference in the postoperative back pain score was also insignificant (P=0.821). These two groups were not different in terms of age, pain-free interval, and follow-up duration. Intraoperative blood loss, length of surgery, and length of hospitalization were significantly less in patients undergoing discectomy alone than in patients with fusion. Conclusions:Repeat surgery for recurrent sciatica is effective in cases of true recurrent disc herniation. Disc excision alone is recommended for managing recurrent disc herniation.