To identify the incidence and risk factors for five-year same-site recurrent disc herniation (sRDH) after primary single-level lumbar discectomy. Secondary outcome was the incidence and risk factors for five-year sRDH reoperation. A retrospective study was conducted using prospectively collected data and patient-reported outcome measures, including the Oswestry Disability Index (ODI), between 2008 and 2019. Postoperative sRDH was identified from clinical notes and the centre’s MRI database, with all imaging providers in the region checked for missing events. The Kaplan-Meier method was used to calculate five-year sRDH incidence. Cox proportional hazards model was used to identify independent variables predictive of sRDH, with any variable not significant at the p < 0.1 level removed. Hazard ratios (HRs) were calculated with 95% confidence intervals (CIs).Aims
Methods
The Dynesys fixation device has fewer side effects and complications than conventional fusion techniques, but indications for its use are still unclear. This prospective study of 50 patients treated since October 2000 aimed to determine its efficacy and to establish contra-indications. Patients considered for lumbar spinal fusions were evaluated to assess whether Dynesys fixation could be used instead of conventional fusion techniques. All patients completed an Oswestry questionnaire preoperatively and again three and six months postoperatively. Postoperatively all patients were mobilised on day one or two, using only a soft back brace. No limitations were placed on sitting or driving. All Oswestry and visual pain analogue scores improved dramatically in the short term. Complications included loosening of screws that made further surgery necessary. Three patients required conversion to fusion and one developed
