Ashraf El-Badry¹, Tamer Belal²

Departments of Neurosurgery¹, Neurology², Mansoura University; Egypt

Background: Recurrent herniation represents major cause of failure after surgery for a herniated lumbar disc. Objective: To assess the clinical results in patients undergoing surgery for recurrent disc herniation with those after primary discectomy. Methods: Prospective analytic study was carried out Between March, 2008 and December 2010, 32 patients who underwent surgery for recurrent disc at the same level were analyzed for outcome (group I). Hundred patients who had surgery for primary disc during the same period was included as control (group 2). Results: In 52% of group1 radicular pain related to a precipitating event, but none of the group2 (p<0.001). T2-weighted MRI performed before primary discectomy showed that patients in the group1 had severe disc degeneration compared with the group2 (p=0.02). At 2-year follow-up, the clinical outcome was satisfactory in 87.5% patients in Group1 and in 90% in Group2 (p>0.05). Twenty four patients in Group1 (75%) and 84 in Group2 had returned to their work and daily activities (p>0.05). Radicular pain was improved in both groups at the 6-month and 2-year follow-ups. At 6-month follow-up, low back pain improved only in the patients in Group 2. While after 2 years it improved in both groups. Conclusions: Clinical results in patients for recurrent lumbar disc herniation comparable with those after primary discectomy: the improvement the low back pain and radicular pain reported by the majority of patients 2 years after reoperation. [Egypt J Neurol Psychiat Neurosurg.  2012; 49(4): 335-340]

 Key words: lumber disc, recurrent, reoperation, radicular pain