Recurrent Lumbar Disc Herniation

Forty-six patients who had previously undergone laminectomy and discectomy for lumbar disc herniation were treated for recurrent disc herniation by repeat laminectomy and discectomy. Fifty recurrences were treated in 46 patients, an average of 7 years and 1 month after the previous laminectomy (range 3 months-22 years and 11 months). Thirty-four patients were treated for 37 recurrences at the same level, with three undergoing a third laminectomy and discectomy. Twelve patients were treated for 13 recurrences at a different level. Four patients underwent a third laminectomy and discectomy for recurrent disc herniation. Forty-one patients had follow-up of at least 1 year and average follow-up was 4 years and 6 months (range 1 year-10 years and 8 months). There were 28 good (69%), 10 fair (24%), and 3 poor (7%) results. Patients with pending litigation or work-related injuries (5 good, 5 fair, and 3 poor) did less well overall than those without these issues (23 good, 5 fair, and 0 poor). Fusion is not routinely required in patients undergoing repeat laminectomy and discectomy for recurrent disc herniation. In the absence of objective evidence of spinal instability, recurrent disc herniation may be adequately treated by repeat lumbar laminectomy and discectomy alone.