مقايسه يافته‏هاي باليني و نتايج روش جراحي باز در درمان فتق اوليه با عود ديسك بين مهره‏اي لومبوساكرال

Comparison of clinical findings and results of open surgury in treatment of primary and recurrent lumbosacral disc herniation

Background and Aim: Despite improving therapeutic methods of lumbosacral disc herniation, open surgery is still the conventional method. This study was aimed to investigate the recurrence rate and risk factors of lumbar disc herniation after open surgery and comparison of clinical outcomes of second surgery with the first surgery.Materials and Methods: This prospective descriptive study was performed on patients with disc herniation surgery during 5 years (March 2003 to 2008). The questionnaires including personal information, clinical findings and neurological examination were completed for all patients before and after surgery. Pain intensity and function of patient were evaluated by visual analogue scale (VAS) and MODQ respectively. Data were analyzed by mean of SPSS software (version 12) and appropriate statistical test at the significant level of P<0.05.Results: In this study, 844 patients with mean follow-up period of 38±8 month were studied. The most common complaints and signs of the patients were Low back pain, sciatalgia and positive SLR respectively. Recurrence of symptoms was confirmed by MRI in 16 patients (1.89%). Relapse risk factors were sex, age, smoking and spine trauma. Comparison of pain severity and function rate in group with primary hernia (86.7% and 21.2 respectively) with recurrent group (85.7% and 21.1 respectively) showed no significant difference (P>0.05).Conclusion: While this study, determined the incidence of recurrent disk herniation, it showed that the results of the second surgery were satisfactory and the complications is not more than the first surgery.