Introduction: Lumbar disc herniation(LDH) recurrence necessitating reoperation can pose problems following spinal surgery, with an overall reported incidence of approximately (3–13%). The purpose of this study is to identify the rate of recurrence disc herniation, to discuss the radiologic indications for herniotomy and to analyze clinical outcomes compared with conventional discectomy
Methods: The authors retrospectively reviewed 114 patients who underwent herniotomy & conventional discectomy by a single surgeon for single-level LDH between June 2009 and May 2012. Evaluation for LDH recurrence included detailed medical chart and radiologic review and telephone interview. Postoperative VAS and the Korean version of ODI were examined one week after surgery. Clinical outcome was investigated following Odom's criteria from three months to three years.
Results: Of the 57 patients for whom the authors were able to definitively assess symptomatic recurrence status, four patients (7%) experienced LDH recurrence following single-level herniotomy and three patients (5.2%) conventional discectomy. Postoperative VAS decreased more following conventional discectomy than herniotomy, but the difference was not significant. There were no differences in the Korean version of ODI between herniotomy group and conventional discectomy group. The herniotomy group had better results than the conventional discectomy group in clinical outcome from three months to three years, but the difference was not significant.
Conclusions: There were no significant differences in clinical outcome between herniotomy and conventional discectomy. Recurrence rates following herniotomy for LDH compare favorably with those in patients who have undergone conventional discectomy, lending further support for its effectiveness in treating herniotomy.
Patient Care: We carry out herniotomy in patient that had free fragment, low continuity with disc space and minimal disc protursion of parent disc on MR. So postoperative back pain and operating time can be decreased.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe effectiveness of herniotomy 2) Identify proper treatment in lumbar disc herniation.
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