Primary and revision lumbar discectomy. A 16-year review from one centre.

Abstract

We present a review of 553 patients who underwent surgery for intractable sciatica ascribed to prolapsed lumbar intervertebral disc. One surgeon in one institution undertook or supervised all the operations over a period of 16 years. The total number of primary discectomies included in the study was 531, of which 42 subsequently required a second operation for recurrent sciatica, giving a revision rate of 7.9%. Factors associated with reoperation were analysed. A contained disc protrusion was almost three times more likely to need revision surgery, compared with extruded or sequestrated discs. Patients with primary protrusions had a significantly greater straight-leg raise and reduced incidence of positive neurological findings compared with those with extruded or sequestrated discs. These patients should therefore be selected out clinically and treated by a more enthusiastic conservative programme, since they are three times more likely to require revision surgery.

• Authors: C V J Morgan-Hough, P W Jones, S M Eisenstein
• Journal: The Journal of bone and joint surgery. British volume (J Bone Joint Surg Br) Vol. 85 Issue 6 Pg. 871-4 (Aug 2003) ISSN: 0301-620X [Print] England
• PMID: 12931809 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Diskectomy (methods)
• Female
• Humans
• Intervertebral Disc Displacement (complications, surgery)
• Lumbar Vertebrae
• Male
• Middle Aged
• Nervous System Diseases (etiology)
• Odds Ratio
• Postoperative Complications (etiology)
• Recurrence
• Reoperation
• Risk Factors
• Sciatica (etiology, surgery)
• Sex Factors
• Time Factors