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Multiple Surgery Risks Following Lumbar Discectomy

More and more people are having lumbar discectomy worldwide. This surgery is used to remove damaged disc tissue from the low back. However, there is only limited evidence of the surgery's effectiveness in treating low back problems. Some research even suggests that it has poor results.

These authors did a large-scale review of medical records in Finland to make some sense of the controversy surrounding this procedure. They looked especially at the risk of needing further back surgeries afterward. Over 10 years, more than 35,000 patients had a lumbar discectomy. The researchers noted several interesting facts about the patients who needed further surgery.

  • Fourteen percent of the patients needed another operation afterward; just over two percent needed more than one surgery.
  • If another surgery was needed, there was a one in four chance of needing a third or fourth operation.
  • The method used when more than one surgery was needed included discectomy (63 percent), decompression (23 percent), or fusion (14 percent).
  • Patients who had a fusion surgery after the first discectomy were less likely to need more operations. (The authors caution that this doesn't mean fusion surgery is necessarily the best choice. It could mean that fusion surgery was a last resort for especially difficult problems.)
  • Patients older than 50 and patients whose first reoperation was more than a year later than the first surgery were also less likely to need further operations.
  • The risk of reoperation was the same for men and women.

    The article highlights the problems in understanding when lumbar discectomy might be a good option. They suggest that ongoing problems afterward could mean that the back condition is especially bad, that the surgical technique is not good, or that doctors aren't always doing a good job of sorting out which patients are best suited for discectomy. They recommend more research to help understand why this surgery has generally poor outcomes.

    Heikki Österman, MD, et al. Risk of Multiple Reoperations After Lumbar Discectomy: A Population-Based Study. In Spine. March 15, 2003. Vol. 28. No. 6. Pp. 621-627.


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