The Chance of Lumbar Discectomy Reoperation

The Chance of Lumbar Discectomy Reoperation

The Chance of Lumbar Discectomy Reoperation

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In general appropriate properly selected patients do well with lumbar discectomy surgery.  By definition,  a properly selected patient is one who has a well defined disk herniation on diagnostic testing,  with corresponding physical examination findings of neurotension  (straight leg raise findings), and identified loss of sensation,  reflex changes and/or weakness that follows a specific nerve distribution.  If that person does not improve despite 6-8 weeks of time and non surgical treatments,  there is usually a 95% success rate in terms of reduction of symptom.

The concern is about potential for repeat surgery in the future.  It is a possibility,  and many think repeat surgery is inevitable.  The real data is not that bleak.

In 2000,  the Spine Patient Outcomes Research Trial (SPORT) started collecting data on patients undergoing various lower back spine surgeries.  There been many articles written about the results of the study.  Recently,  in the August 2015 Journal of Bone and Joint Surgery,  Leven et al reviewed the data on the “Risk Factors for Reoperation in Patients Treated Surgically for Intervertebral Disc Herniation”.

The article was full of take home points.

  1. At 8 years,  there was a 15% reoperation rate.
  2. 62% of the operations were for recurrent disk herniations  at the same level
  3. 25% of the operations were secondary to complications from the initial operation
  4. 11% of the operations were secondary for a new condition.
  5. Older patients were less likely to have reoperations

While 15% still seems like a large number,  it is definitely less than what most of my patients think will happen.

If you are ever asked the chance for repeat spine surgery after lumbar discectomy,  it is perfectly fine to say  “you are less likely to need further spine surgery after discectomy”.    While there are no guarantee’s,  for the properly selected, and counseled patient,  lumbar discectomy is a reasonable option.

 

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Author and Contributor to www.Spine-Health.com – July, 2015

www.Spine-Health.com/author/john-h-shim-md-facs

Chief of Surgery, Mease Countryside and Mease Dunedin Hospitals, Safety Harbor and Dunedin, Florida. 2014-2016.

Orthopaedic Section Chief Mease Countryside Hospital; Safety Harbor, Florida Mease Dunedin Hospital; Dunedin, Florida.2008-2013

Board Member Morton Plant Mease Research Council

Co-Director of Mease Neuro-Ortho Spine Center Mease Dunedin Hospital; Dunedin, Florida.

One of “6 Spine Physicians Ranked #1 on Google” – December 2016

Top Ten Most Liked Spine Surgeons on the Internet – July 2016

2016 Spine Surgeons to Know list – January 2016

2014 Spine Specialists to know list – September 2014

One of Ten Leaders of Certified Spine Programs – December 2011

 

The Best Orthopedics in Tampa

The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.
Outpatient Spine Surgery Considerations. www.Spine-Health.com. January 2016.

What is Spinal Stenosis? www.Spine-Health.com. October 2015.

Surgeon insights on the Changing Landscape of Orthopedic Care. OrthopedicToday. June 2014

Chapter 33: Interspinous Spacers. Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

Chapter 35: Minimally Invasive Percutaneous Lumbar Fusion Technique.Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

March 2010 Minimally Invasive Transforaminal Lumbar Interbody Fusion American Academy of Orthopaedic Surgeons Annual Meeting New Orleans, Louisiana February 2010

February 2010 A Review of Dynamic Stabilization in the Lumbar Spine Selby Spine Symposium; Park City, Utah

November 2009 Lumbar Spinal Stenosis Community Based Lecture; Tampa, Florida

September 2009 Instructor/Proctor Minimally Invasive Lumbar Cadaver Lab; Tampa, Florida

February 2009 New Spinal Technology: Cervical Disc Replacement and Interspinous Spacers. Selby Spine Symposium; Park City, Utah

February 2008 The Degenerative Spine: The Role of Dynamic Lumbar Stablization and Interspinous Spacers Selby Spine Symposium; Park City, Utah

October 2008 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

September 2007 Emerging Technology in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

October 2006 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

May 2005 The Role of Kyphoplasty in the Treatment of Vertebral Compression Fractures Mease Neurosciences Symposium; Clearwater, Florida
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