Outcome of revision discectomies following recurrent lumbar disc herniation.

STUDY DESIGN: Retrospective study.

OBJECTIVES: To assess the difference in the outcome score between a primary surgery to treat lumbar disc herniation and a revision surgery for recurrent herniation at the same location with the use of a validated lumbar spine outcome instrument.

SUMMARY OF BACKGROUND DATA: Paucity of studies comparing the results of revision discectomy for true recurrent disc herniation at the same location to that reported for primary discectomy.

METHODS: A total of 27 patients who had undergone revision discectomies for recurrent lumbar disc herniations were surveyed to assess their clinical outcomes. Patients were compared with a control group of 30 matched patients who had undergone only a primary discectomy. The spine module of the MODEMS outcome instrument was used to evaluate the patients' satisfaction, their pain and functional ability following discectomy, as well as their quality of life. All patients were also asked whether they were improved or worsened with surgery. Those undergoing revision surgery were asked whether the improvement following the second surgery was more or less than the improvement following the first surgery.

RESULTS: Improvement following the repeat discectomy was not statistically different from the improvement that occurred in patients who underwent just the primary operation. Differences in residual numbness/tingling in the leg and/or the foot as well as in frequency of back and/or buttock pain were identified.

CONCLUSION: Based on patient derived outcome data using a validated instrument, revision discectomy is as efficacious as primary discectomy in selected patients.