Reoperation for recurrent lumbar disc herniation: a study over a 20-year period in a Japanese population

被引：118

作者：

Aizawa, Toshimi ^{[1
]}

Ozawa, Hiroshi ^{[1
]}

Kusakabe, Takashi ^{[1
]}

Nakamura, Takeshi ^{[1
]}

Sekiguchi, Akira ^{[1
]}

Takahashi, Atsushi ^{[1
]}

Sasaji, Tatsuro ^{[2
]}

Tokunaga, Shigeyuki ^{[3
]}

Chiba, Tomonori ^{[4
]}

Morozumi, Naoki ^{[5
]}

Koizumi, Yutaka ^{[5
]}

Itoi, Eiji ^{[1
]}

机构：

[1] Tohoku Univ, Sch Med, Dept Orthopaed Surg, Aoba Ku, Sendai, Miyagi 9808574, Japan

[2] Tohoku Rosai Hosp, Dept Orthopaed Surg, Sendai, Miyagi, Japan

[3] Sendai Orthopaed Hosp, Dept Orthopaed Surg, Sendai, Miyagi, Japan

[4] Sen En Gen Hosp, Dept Orthopaed Surg, Tagajo, Miyagi, Japan

[5] Nishitaga Natl Hosp, Dept Orthopaed Surg, Sendai, Miyagi, Japan

来源：

JOURNAL OF ORTHOPAEDIC SCIENCE | 2012年 / 17卷 / 02期

关键词：

THORACIC MYELOPATHY; OUTCOMES; SURGERY; SCIATICA;

D O I：

10.1007/s00776-011-0184-6

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

100224 [整形外科学];

摘要：

Many studies have been reported on recurrent lumbar disc herniations covering several pathological conditions. In those studies, reoperation rate of revised disc excisions was calculated by simple division between the number of reoperations and that of the total primary disc excisions. To determine the real reoperation rate, strict definition of pathologies, a large number of patients, a long observation period, and survival function method are necessary. Between 1988 and 2007, 5,626 patients with disc excision were enrolled by the spine registration system of the Department of Orthopaedic Surgery, Tohoku University, Japan. Among them, 192 had revised disc surgery, and we obtained data of 186 patients whose clinical features were assessed and reoperation rates analyzed using the Kaplan-Meier method. In total, 205 disc herniations were excised in the revision surgery (including contralateral herniation at the same level and new herniation at a different level), and 101 were real recurrent herniations (recurrence at the same level and side as the primary herniation). The kappa coefficient of the spinal level and side between the primary and revision surgeries was 0.41, indicting moderate correlations. Real recurrent herniations showed shorter intervals between primary and revision surgeries. Male patients with surgery at a younger age carried a higher risk of reoperation. In the revision surgery, transligamentous extrusion was significantly more common than other types of herniation. On Kaplan-Meier analysis, the reoperation rate of overall revised excisions was 0.62% at 1 year, 2.4% at 5 years, 4.4% at 10 years, and 5.9% after 17 years. That of real recurrent herniations was 0.5%, 1.4%, and 2.1%, respectively, and 2.8% after 15.7 years. Reoperation rate of real recurrent herniations calculated using survival function method gradually increased year by year, from 0.5% at 1 year after primary surgery to 2.8% at 15.7 years.

引用

页码：107 / 113

页数：7

共 29 条

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