Effect of surgical treatment on recurrent lumbar disc herniation and the selection of treatment methods

Objective To investigate the therapeutic effect on recurrent lumbar disc herniation and selection of treatment methods.Methods Fifty-two casels of recurrent lumbar disc herniation were performed with different methods of reoperation.of all the cases.11 were treated with enlarged fenestration at the initially operated site.Hemilaminectomy and partial facets joint were removed in 13 cases.Fifteen cases with lumbar instability were treated with hemilaminectomy combined with pedicle screw system and one cage inserted lumbar spatial and auto bone grafting at the other side lamina.Thirteen cases with instability and total laminectomy were treated with decompression and PLIF with one cage and one mass of bone graft in lumbar space.Results Au the patients had clinical follow-ups for 5 to 72 months.Results showed that symptoms in all the operated patients obviously relieved the day after surgery,almost disappeared in 3 weeks to 6 months.According to JOA score system criteria,average score increased from 10.9 before reoperation to 25.8 after reoperation.X-ray film revealed that lumbar instability was not seen in the 24 cases operated for removal of nucleus pulposus with enlarged fenestration,good vertebral joint fusion could be seen in 28 cases treated with screw fixation at pedicle of vertebral arch.Conclusions For patients who had recurrent lumbar disc herniation and did not respond to conservative treatment,ideal results could be achieved with correct selection of reoperation. Key words: Lumbar disc herniation; Recurrent; Surgical re-treatment