Impact of comorbidities on outcome following revision of recurrent single-level lumbar disc prolapse between revision microdiscectomy and posterior lumbar interbody fusion: A single-institutional analysis

Chiazor Onyia; Sajesh Menon

doi:10.4103/ajns.AJNS_299_18

Asian Journal of Neurosurgery, Table of Contents

CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(02): 392-398
DOI: 10.4103/ajns.AJNS_299_18

Original Article

Impact of comorbidities on outcome following revision of recurrent single-level lumbar disc prolapse between revision microdiscectomy and posterior lumbar interbody fusion: A single-institutional analysis

Chiazor Onyia

Department of Surgery, Lagoon Hospitals, Lagos

,

Sajesh Menon

¹Department of Neurosurgery, Amrita Institute of Medical Sciences and Research, Kochi, Kerala

› Author Affiliations

Abstract

Objectives: Reports exist in the literature on the relationship between comorbid conditions and recurrence of lumbar disc herniation. Meanwhile, documented evidence abound on microdiscectomy and posterior lumbar interbody fusion (PLIF) as techniques of managing recurrent disc prolapse. Some surgeons would choose to perform PLIF instead of microdiscectomy for a first time re-herniation, because of the possibility of higher chances of further recurrence as well as increased likelihood of spinal instability following treatment with microdiscectomy. In this study, the authors sought to determine whether PLIF is better than microdiscectomy for first-time recurrent single-level lumbar disc prolapse and to compare the impact of comorbidities on outcome following revision. Patients and Methods: This was retrospective review of surgical treatment of patients with recurrent single-level disc prolapse with either microdiscectomy or PLIF at a tertiary health institution in India. Results: A total of 26 patients were evaluated. There was no statistically significant correlation between the presence of comorbidity and outcome in terms of improvement of pain (P > 0.05 at 95% degree of confidence; Spearman's ρ =0.239). Patients who had PLIF were neither more nor less likely to have a better outcome compared to those who had microdiscectomy, though this finding was not statistically significant (odds ratio = 0.263; P = 0.284). Conclusion: There was no significant relationship between the presence of comorbidity and outcome following revision. Microdiscectomy did not prove to be a better option than PLIF for surgical management of recurrent single-level disc prolapse. A quality randomized controlled study would help to validate these findings.

Key-words:

Posterior lumbar interbody fusion - recurrent single-level disc prolapse - revision microdiscectomy - revision surgery

Full Text

References

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