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Repeat Discectomy or Instrumented Surgery for Recurrent Lumbar Disk Herniation: An Overview of French Spine Surgeons’ Practice – Lumbar Fusion

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The article published in Global Spine Journal discusses a retrospective multicenter cohort study focusing on the choice between repeat microdiscectomy (RD) and instrumented surgery (IS) for recurrent lumbar disc herniation (ReLDH). The study aimed to understand the indications for each procedure and compare their results, specifically looking at the practice of spine surgeons in France. The results showed that factors such as radioclinical elements, anatomical data, patient preferences, and surgeon background influenced the choice of procedure. Patient satisfaction, return to work, and changes in patient-reported outcome measures (PROMs) were not significantly different between the RD and IS groups at 12 months postoperatively. The decision-making process included both objective and subjective factors, leading to patient satisfaction in the majority of cases and significant clinical improvement in symptoms and quality of life depending on the procedure performed

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most specialised spinal centre in UK

Published article

S: The decision-making process included both objective and subjective factors, resulting in patient satisfaction in 80.3% to 81.5% of cases, with significant clinical improvement in radicular symptoms in 75.8% to 91.8% of cases, and quality of life in 75.8% to 84.9% of cases, depending on the procedure performed.

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Global Spine J. 2024 Apr 23:21925682241249102. doi: 10.1177/21925682241249102. Online ahead of print. ABSTRACT STUDY DESIGN: Retrospective multicenter cohort study. OBJECTIVE: Recurrent lumbar disc herniation (ReLDH) is a common condition requiring surgical intervention in a large proportion of cases. Evidence regarding the appropriate choice between repeat microdiscectomy (RD) and instrumented surgery (IS) is lacking. To understand,

Global Spine J. 2024 Apr 23:21925682241249102. doi: 10.1177/21925682241249102. Online ahead of print.

ABSTRACT

STUDY DESIGN: Retrospective multicenter cohort study.

OBJECTIVE: Recurrent lumbar disc herniation (ReLDH) is a common condition requiring surgical intervention in a large proportion of cases. Evidence regarding the appropriate choice between repeat microdiscectomy (RD) and instrumented surgery (IS) is lacking. To understand the indications for either of the procedures and compare the results, we aimed to provide an overview of spine surgeon practice in France.

METHODS: This retrospective, multicenter analysis included adults who underwent surgery for ReLDHs between December 2020 and May 2021. Surgeons were asked which of the following factors determined their therapeutic choice: radio-clinical considerations, non-discal anatomical factors, patient preference, or surgeon background. Data on preoperative clinical status and radiologic findings were collected. Patient-reported outcome measures (PROMs) were assessed and compared using propensity scores preoperatively and at 3 and 12 months postoperatively.

RESULTS: The study included 150 patients (72 IS and 78 RD). Radioclinical elements, anatomical data, patient preferences, and surgeon background influenced the choice of RD in 57.7%, 1.3%, 25.6%, and 15.4% of the cases, respectively, and IS in 34.7%, 6.9%, 13.9%, and 44.5% of the cases, respectively. At 12 months, patient satisfaction, return to work, and changes in PROMs were not significantly different between the groups.

S: The decision-making process included both objective and subjective factors, resulting in patient satisfaction in 80.3% to 81.5% of cases, with significant clinical improvement in radicular symptoms in 75.8% to 91.8% of cases, and quality of life in 75.8% to 84.9% of cases, depending on the procedure performed.

PMID:38652921 | DOI:10.1177/21925682241249102

The London Spine Unit : most specialised spinal centre in UK

Read the original publication:

Repeat Discectomy or Instrumented Surgery for Recurrent Lumbar Disk Herniation: An Overview of French Spine Surgeons’ Practice

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Global Spine J. 2024 Apr 23:21925682241249102. doi: 10.1177/21925682241249102. Online ahead of print. ABSTRACT STUDY DESIGN: Retrospective multicenter cohort study. OBJECTIVE: Recurrent lumbar disc herniation (ReLDH) is a common condition requiring surgical intervention in a large proportion of cases. Evidence regarding the appropriate choice between repeat microdiscectomy (RD) and instrumented surgery (IS) is lacking. To understand

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