J Korean Neurosurg Soc.  2008 Nov;44(5):320-326. 10.3340/jkns.2008.44.5.320.

Contralateral Reherniation after Open Lumbar Microdiscectomy : A Comparison with Ipsilateral Reherniation

Affiliations
  • 1Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Korea. nsspine@paran.com

Abstract


OBJECTIVE
To evaluate the risk factors that may be responsible for the development of contralateral reherniations from ipsilateral ones after open lumbar microdiscectomy (OLM), and to compare surgical outcomes of revision OLM for contralateral reherniations with those for ipsilateral ones.
METHODS
Seventeen patients who underwent revision OLM for contralateral reherniation were enrolled into Group I, and 35 patients who underwent revision OLM for ipsilateral reherniation were enrolled into Group II. Using medical charts and imaging study results, the differences in the clinical and radiological factors were evaluated between the two groups. Clinical outcomes of each group were compared between the two groups.
RESULTS
Significant differences were found in the interval to reherniation from initial surgery (33 months for Group I and 18.6 months for Group II, p=0.009), as well as in the incidences of both protruded disc (35.3% for Group I and 8.6% for Group II, p=0.045) and mild disc degeneration (29.4% for Group I and 5.7% for Group II, p=0.031) at initial surgery. On binary multi-logistic regression analysis, significant differences were found in the interval to reherniation (p=0.027, Odds ratio=1.051) and incidence of mild disc degeneration (p=0.025, Odds ratio=12.03) between the two groups. There were no significant differences in the improvement of clinical outcomes after revision OLM between the two groups.
CONCLUSION
The interval to reherniation from initial surgery and the grade of disc degeneration at initial surgery were key factors that distinguished the development of contralateral reherniations from ipsilateral ones. Surgical outcomes of revision OLM were similar in both groups.

Keyword

Reherniation; Discectomy; Lumbar spine

MeSH Terms

Diskectomy
Humans
Incidence
Intervertebral Disc Degeneration
Risk Factors
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