Journal List > J Korean Soc Spine Surg > v.9(3) > 1036014

Shim, Kim, Song, Kim, Kim, Chae, So, and Shin: Clinical Characteristics of Contralateral Recurrent Lumbar Disc Herniation at the Same Level - A Retrospective Controlled Study

Abstract

Study Design

A retrospective study of patients with contralateral recurrent lumbar disc herniation at the same level. Objectives : To analyze the risk factors of recurrence, clinical result and reoperative efficiency of contralateral recurrent lumbar disc herniation at the same level after primary discectomy compared with those after discectomy in primary lumbar disc herniation.

Summary of Literature Review

There have been many studies on recurrent disc herniation, but little investigation of risk factors and clinical result of contralateral recurrent lumbar disc herniation at the same level.

Materials and Methods

Ten cases who can investigate for 2 years among the patients who underwent reoperation for contralateral recurrent lumbar disc herniation at the same level after primary discectomy were selected as study group (groupⅠ) and thirty cases who underwent discectomy during the same study period were selected as control group (groupⅡ). A ge, gender, etiology and symptom of disc herniation, clinical improvement rate and amount of remove disc were recorded. Overall patient satisfaction, pain severity, functional outcome and work status were evaluated. Risk factors of recurrence were analyzed.

Results

Etiology was no different between both groups but showed the abrupt onset symptom in study group. Recurrence was more common in the case herniated posterolaterally and had severe degeneration change in lumbar disc before primary discectomy. The amount of bulging disc removed were average 1.5 cc in study group and 2.5 cc in control group. Recurrence was more in the cases removed smaller amount of bulging disc and remained the symptom of pain after primary discectomy. Clinical result show the same between both group after 2 years (p>0.05).

Conc lusio ns

Contralateral recurrent disc herniation at the same level mainly has abrupt symptom and more in the cases degenerated discs. Recurrence was more common in the cases removed smaller amount of bulging disc and remained the symptom after primary discectomy.

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Figures and Tables%

Fig. 1.
T2-weight axial MR image shows left-side extrusion of the L4-5 disc and the bottom MR image shows right-side extrusion of the recurrent disc at the same level.
jkss-9-184f1.tif
Table 1.
Symptom & Sign
Sx Group Group Ⅰ (1st OP) Group Ⅰ(2nd OP) Group Ⅱ
Back pain 10(100%) 8 (80%) 29(96.7%)
Radiating pain 9 (90%) 10(100%) 25(83.3%)
SLRT 7 (70%) 5 (50%) 16(53.3%)
Claudication 3 (30%) 2 (20%) 13(43.3%)
Motor weakness - 1 (10%) 4(13.3%)
Table 2.
Pain severity
Group GroupⅠ(2nd OP) Group Ⅱ
Sx Pre OP 6mo F/U 2yr F/U Pre OP 6mo F/U 2yr F/U
Back pain 5.2 4.4 3.1 5.4 3.1 2.8
Radicular pain 8.9 2.2 1 7.5 2.4 1.2
Table 3.
Functional state
Group OP date Group Ⅰ(1st OP) Group Ⅰ(2nd OP) Group Ⅱ
Pre OP 17.2 16.7 17.3
6mo F/U 4.1 5.7 4.2
2yrs F/U 3.8 3.0
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