{"id":"e06b98a1-c14e-4564-bcbd-8debfc1043db","slug":"repeat-discectomy-for-recurrent-same-level-disc-herniation-a-literature-review-of-the-past-5-years","title":"Repeat discectomy for recurrent same level disc herniation: A literature review of the past 5 years","authors":["Gerald Musa","Rossi E.C Barrientos","Serik K. Makirov","Gennady E. Chmutin","Gennady I. Antonov","Alexander V. Kim","Olzhas Otarov"],"abstract":"Background: Recurrent disc herniations remain a challenge in spinal surgery. Although some authors recommend a repeat discectomy, others offer more invasive secondary fusions. Here, we reviewed the literature (2017–2022) regarding the safety/efficacy of treating recurrent disc herniations with repeated discectomy alone. Methods: Our literature search of recurrent lumbar disc herniations included; Medline, PubMed, Google scholar, and the Cochrane database. We focused on the types of discectomy performed, perioperative morbidity, costs, length of surgery, pain scores, and incidence of secondary dural tears. Results: We identified 769 cases that included 126 microdiscectomies, and 643 endoscopic discectomies. Rates of disc recurrence ranged from 1% to 25% with accompanying secondary durotomy varying from 2% to 15%. In addition, operative times were relatively short, ranging from 29.2 min to 125 min, with a relatively small average estimated blood loss (i.e., minimal to maximally 150 mls). Conclusion: Repeated discectomy was the most commonly performed treatment for same-level recurrent disc herniations. Despite minimal intraoperative blood loss and short operating times, there was a significant risk of durotomy. Notably, patients must be informed that more extensive bone removal for treating recurrent disc increases the risk for instability warranting subsequent fusion.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/e06b98a1-c14e-4564-bcbd-8debfc1043db/featured/hero-1781560432039.png","publishDate":"2023-03-24T00:00:00.000Z","doi":"10.25259/SNI_168_2023","categories":["Spine","Review Article"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/e06b98a1-c14e-4564-bcbd-8debfc1043db/pdf"}