Determining the Extent of Lumbar Discectomy in Patients with Herniated Lumbar Discs

Tel: 401-793-9136 Fax: 401-444-2781 Lumbar discectomy for lumbar disc herniation is one of the most common spine procedures performed. The incidence of symptomatic herniated lumbar discs is estimated to be between 1-2% [1] and over 480,000 lumbar discectomies are performed annually in the United States [2, 3]. Lumbar discectomies are effective in relieving back and leg pain [4] and patient outcomes and satisfaction after discectomy have been reported in 7580% of patients receiving surgery [5-7]. However, a common complication after lumbar discectomy is recurrence of herniated disc which has been reported to occur in the range of 3-18% [8, 9]. Recurrent lumbar disc herniation is usually treated with open technique with wider exposure for discectomy, or in cases of significant instability and/or loss of disc height, lumbar interbody fusion [10]. This complication results in increased patient hospitalization and cost as well as missed work days. All of these contribute to an increased economic burden on the United States health care system [8, 9]. It has been estimated that reoperation for recurrent herniated discs in the lumbar spine resulted in a normalized cost of $298,797 per 100 primary discectomies in the setting of a recurrence rate of 12% [11].