Clinical Results about More than 5 Years Followup after Open Discectomy

Jae-Wan Soh; Jae Chul Lee; Hyung-Mo Goo; Hae-Dong Jang; Byung-Joon Shin

doi:10.4184/jkss.2011.18.3.140

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Soh, Lee, Goo, Jang, and Shin: Clinical Results about More than 5 Years Followup after Open Discectomy

Original Article

Journal of Korean Spine Surg 2011;18(3):140-145.

Published online: 21 September 2011

DOI: https://doi.org/10.4184/jkss.2011.18.3.140

Clinical Results about More than 5 Years Followup after Open Discectomy

Jae-Wan Soh, M.D.^∗, Jae Chul Lee, M.D., Hyung-Mo Goo, M.D., Hae-Dong Jang, M.D., Byung-Joon Shin, M.D.

Department of Orthopaedic Surgery, Soonchunhyang University College of Medicine, Seoul, Korea

^∗Department of Orthopaedic Surgery, Soonchunhyang University Cheonan Hospital, Korea

Corresponding author: Byung-Joon Shin, M.D. Department of Orthopaedic Surgery, Soonchunhyang University College of Medicine, 657, Hannam-dong, Yongsan-gu, Seoul, Korea TEL: 82-2-709-9250, FAX: 82-2-794-9414 E-mail: schsbj@schmc.ac.kr

Received 4 May 2011 Revised 19 July 2011 Accepted 19 July 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

Retrospective study.

Objectives

We analyzed to verify clinical result and recurrence of long term followup after open lumbar discectomy.

Summary of Literature Review

There are many reports concerning the clinical result of open discectomy. However, longterm result is not frequently reported.

Materials and Methods

From 1989 to 2000, 289 patients underwent open discectomies. 142 patients who was followed more than 5 years were enrolled in this study. Followup rate, clinical outcome were analyzed as gender, age at the operation and operated level. Reoperation rate was analyzed as gender, age at the operation, operated level divided into same level-same side, same level-contralateral side and other level and the time at reoperation. Clinical outcomes were evaluated by Kim and Kim criteria.

Results

More than 5 years followup rate was 49.1%. Average followup period were 99.2 months. Clinically successful result was obtained in 75.4%, and it was not related with gender, age at the operation and operated level. Reoperations were needed in 21 patients(14.8%). Reoperation rate was not related with gender, age at the operation. Same level-same side reherniation were frequent before 6 months after first surgery, but other side and different level were similar more than 2 years after first surgery.

Conclusions

Our clinical result was acceptable(75.4%). Main cause of reoperations before 6 months after first surgery was recurrence at the same level and same side, but cause of reoperation more than 2 years after first surgery were herniation at the other side and different level increased with time.

Keywords: Lumbar spine, Herniated intervertebral disc, Open discectomy, Reoperation

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Table 1.

Five year followup rate, satisfactory rate and reoperation rate after open discectomy

		No. of total operatied	No. of Followed	5 Y *FU rate(%)	^† E	^‡ G	∮ F	^∥ P	¶Satisfactory rate(%)	Reoperation	Reoperation rate(%)
Sex	M	204	100	49.0	38	40	8	14	78.0	14	14.0
	F	85	42	49.4	15	14	5	8	69.0	7	16.7
Age	<30	100	50	50.0	23	14	7	6	74.0	6	12.0
	31-45	97	50	51.5	18	21	3	8	76.0	8	16.0
	>46	92	42	45.7	12	19	3	8	73.8	7	16.7
Level	L5-S1	73	35	47.9	15	11	6	3	74.3	4	11.4
	L4-5	195	94	48.2	33	39	7	15	76.6	13	13.7
	>L3-4	21	13	61.9	5	4	0	4	69.2	4	30.8
Total		289	142	49.1	53	54	13	22	75.4	21	14.8

*FU; followup †E; excellent, ‡G; good

^∮ F; fair,

^∥ P; poot ¶Satisfactory = E(excellent) + G(good)

Table 2.

Reoperation of disc site according to time

	<6^∮ M	6M-2^∥ Y	2-5Y	>5Y	Total	Time(M)	%
*S, S	5	1	2	3	11	32.5	52.4
^† S, C	0	1	2	3	6	62.4	28.6
^‡ O	0	0	1	3	4	90.8	19.0
Total 5	5(23.8%)	2(9.5%)	5(23.8%)	9(42.5%)	21(100%)	52.1	100

*S, S; same level-same side

^† S, C; same level-contralateral side

^‡ O; other level

^∮ M; month,

^∥ ∥ Y; year

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