Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Apr;9(2):202-209.
doi: 10.1177/2192568217745063. Epub 2017 Dec 18.

Recurrent Lumbar Disc Herniation: A Review

Nicholas Shepard  1 , Woojin Cho  2   3
Affiliations
Review

Recurrent Lumbar Disc Herniation: A Review

Nicholas Shepard et al. Global Spine J. 2019 Apr.

Abstract

Study design: Narrative review.

Objectives: To identify the risk factors and surgical management for recurrent lumbar disc herniation using a systematic review of available evidence.

Methods: We conducted a review of PubMed, MEDLINE, OVID, and Cochrane Library databases using search terms identifying recurrent lumbar disc herniation and risk factors or surgical management. Abstracts of all identified articles were reviewed. Detailed information from articles with levels I to IV evidence was extracted and synthesized.

Results: There is intermediate levels III to IV evidence detailing perioperative risk factors and the optimal surgical technique for recurrent lumbar disc herniations.

Conclusions: Multiple risk factors including smoking, diabetes mellitus, obesity, intraoperative technique, and biomechanical factors may contribute to the development of recurrent disc disease. There is widespread variation regarding optimal surgical management for recurrent herniation, which often include revision discectomies with or without fusion via open and minimally invasive techniques.

Keywords: discectomy; fusion; lumbar disc herniation; microdiscectomy; recurrent herniation.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. Carragee EJ, Han MY, Suen PW, Kim D. Clinical outcomes after lumbar discectomy for sciatica: the effects of fragment type and anular competence. J Bone Joint Surg Am. 2003;85-A:102–108. - PubMed
    1. Wera GD, Marcus RE, Ghanayem AJ, Bohlman HH. Failure within one year following subtotal lumbar discectomy. J Bone Joint Surg Am. 2008;90:10–15. - PubMed
    1. Rogers LA. Experience with limited versus extensive disc removal in patients undergoing microsurgical operations for ruptured lumbar discs. Neurosurgery. 1988;22(1 pt 1):82–85. - PubMed
    1. O’Sullivan MG, Conolly AE, Buckley TF. Recurrent lumbar disc protrusion. Br J Neurosurg. 1990;4:319–325. - PubMed
    1. Lebow RL, Adogwa O, Parker SL, Sharma A, Cheng J, McGirt MJ. Asymptomatic same-site recurrent disc herniation after lumbar discectomy: results of a prospective longitudinal study with 2-year serial imaging. Spine (Phila Pa 1976). 2011;36:2147–2151. - PubMed

LinkOut - more resources