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Risk Factors of Secondary Lumbar Discectomy of a Herniated Lumbar Disc after Lumbar Discectomy

Journal of Korean Neurosurgical Society 2019년 62권 5호 p.586 ~ 593
 ( Beack Joo-Yul ) - Hanyang University Medical Center Department of Neurosurgery

 ( Chun Hyoung-Joon ) - Hanyang University Medical Center Department of Neurosurgery
 ( Bak Koang-Hum ) - Hanyang University Medical Center Department of Neurosurgery
 ( Choi Kyu-Sun ) - Hanyang University Medical Center Department of Neurosurgery
배인석 ( Bae In-Suk ) - Hanyang University Medical Center Department of Neurosurgery
 ( Kim Kee-D. ) - University of California Department of Neurological Surgery

Abstract


Objective : To study risk factors of secondary lumbar discectomy (LD) for recurrent herniated lumbar disc (HLD) and identify methods to lower the rate of recurrence.

Methods : Data from 160 patients who underwent primary LD were collected retrospectively. Demographic features, radiologic findings including Pfirrmann disc degeneration, and surgical information were analyzed to compare risks between revision and non-revision patients.

Results : The revision rate was 15% (24 patients), and the mean follow-up was 28.3 months. HLD recurrence was not related to any demographic characteristics. Primary and secondary LD were most common at the L4?5 level, but the level of operation was not significantly associated with revision. Primary LD most commonly had a Pfirrmann disc degeneration grade of 3, followed by 4. For recurrent HLD, Pfirrmann grade 4 was most common and was statistically significant (p<0.05). A body mass index (BMI) over 30 was considered obese and was significantly related with HLD revision (p<0.05).

Conclusion : Patients with high BMI or severe disc degeneration should be informed of HLD revision.

키워드

Body mass index; Diskectomy; Recurrence; Reoperation
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