1. Hernia recurrence after discectomy: Incidence and Prognosis.
S.Martinez Martos, MT.Ubierna, A.Garcia de Frutos, G.Saló, A. Matamalas and E.Cáceres
Spine Unit. ICATME.Institut Universitari Dexeus
Barcelona.Spain

2. Objective To study the incidence of recurrent
disc herniation on patients diagnosed
of herniated disc that required
surgical treatment.
To find risk factors related with
recurrent disc herniation.

3. List of variables in the study:
Material and methods
Retrospective study of 239 pacients who underwent discectomy
List of variables in the study:
Preoperative
- Age
- Gender
- Level and type of hernia
- Modic changes on MRI
- Disc degeneration
(Pfirrmann)
- Type of surgery performed
- Physical activity at work
- Sports activity
Postoperative
- Oswestry Disability Index
- Physical activity at work
- Sports activity
- Recurrence ocurrence and
percentatge

4. Results. Epidemiology 201 pacients Mean age 42.9 y (19-76) ; 60.25 % ♂
Follow up from 1 to 8 y
83.3% lateral
16,7% foraminal
51.1% left side

5. Results:Disc Degeneration Modic Changes and kind of surgery
58.7% D type (Pfirrmann) , followed by C type 23.9%
33.5% Modic changes, being the type 2 the most common
Magnetic Resonance Classification of Lumbar Intervertebral DiscDegeneration Pfirrmann, Christian W. A.;
Spine. 26(17): , September 1, 2001

6. Results. Oswestry
Oswestry mean result 12.7 (0-96) with better results in ♂ (p=0.00).
Worst results Unemployed (p=0.00).
Best results Sports (Spe )
No correlation between Modic changes,
disc degeneration or type of surgery with
Oswestry results.

7. Results. Hernia recurrence
19.3% (35) hernia recurrence at same level.
13% underwent surgery (28).
No differences between the type of surgery performed in the recurrence with the result in the Oswestry Index (p=0.513)

8. Results. Age & physical activity related with recurrence
No statistically significant
Significant
gender (p=0.665)
sport (p=0.828)
type of hernia(p=0.702)
level of the hernia(p=0.979)
disc degeneration (p=0.526)
extruded (p=0.342)
type of primary surgery
(p=0.549)
age (< 40 years)
physical activity at work

9. Discusion Age ♂♀ DD BMI Modic level Smoking Disc height work Cinotti
Suk
n=28
Kim
n=350
Swatz
n=123
Kyoung- Tae
Etsuro
n=131
Our serie
n=201

10. Conclusion
1.- Good results in the Oswestry index after surgery for lumbar disc herniation
2.- Hernia recurrence after surgery hasn´t been an uncommon fact
3.- Younger people (<40 y) and physical activity at work are related with recurrent lumbar disc herniation
4.- Discectomy or dicectomy plus arthrodesis shows similar results in the revision surgery after hernia recurrence