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Surgical treatment in recurrent lumbar disc herniation: what results?

OBJECTIVES: Concerning treatment for recurrent lumbar disc herniation, especially in surgery, several aspects remain controversial. This work aims to define preoperative characteristics that influence the subjective and objective results of surgery. METHODS: We selected patients undergoing surgery for recurrent lumbar disc herniation over a period of ten years; we reviewed the medical records and reassessed the patients subjectively (degree of satisfaction, Pain Visual Analogue Scale, Stanford Score) and objectively (Oswestry Disability Index, Zurich Questionnaire). A statistical analysis of these data was carried out. RESULTS: The total number was 55 patients, predominantly male. The complication rate was 7.3%. Eleven patients (20%) needed a third surgery. A large majority (91.5%) of patients said they were satisfied with the surgical treatment. There was a favorable average variation of the Oswestry Index (-46.27%), confirmed by other scales; 81.6% of active patients resumed previous work activity. Significant predictors of functional outcome were found and also the need of a third surgical procedure for the return to work activity. CONCLUSIONS: Surgical treatment for recurrent lumbar disc herniation allows a favorable outcome in symptomatic and functional terms in all tests. Some preoperative variables can help predict patients less susceptible to improvement.

Recurrence; Intervertebral disk displacement; Intervertebral disk displacement; Sciatic; Patient satisfaction


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