Evidence map›Paper›PMID 37456489›Full record

ArticleCureus2023

Repeat Discectomy for the Management of Same-Level Recurrent Disc Herniation: A Study of 50 Patients.

Gerald Musa, Serik K Makirov, Sergey V Susin, Gennady E Chmutin, Alexandre V Kim, Dmitri V Hovrin, Dimitri T K Ndandja, Olzhas B Otarov, Hesham M Shaafal, Karina Familia Ramirez

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In one paragraph

Article in Cureus, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.0field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 4 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 3 countries.

Gerald MusaNeurological Surgery, Peoples' Friendship University of Russia (RUDN University) Named After Patrice Lumumba, Moscow, RUS.
Serik K MakirovTrauma and Orthopaedics, Scientific and Technical Center, Family Clinic, Moscow, RUS.
Sergey V SusinGeneral Surgery, Scientific and Technical Center, Family Clinic, Moscow, RUS.
Gennady E ChmutinNeurological Surgery, Peoples' Friendship University of Russia (RUDN University) Named After Patrice Lumumba, Moscow, RUS.
Alexandre V KimNeurological Surgery, City Clinical Hospital Named After V.P Demikhov, Moscow, RUS.
Dmitri V HovrinNeurological Surgery, City Clinical Hospital Named After C.C Yudina, Moscow, RUS.
Dimitri T K NdandjaNeurological Surgery, Peoples' Friendship University of Russia (RUDN University) Named After Patrice Lumumba, Moscow, RUS.
Olzhas B OtarovOrthopaedics and Trauma, Scientific and Technical Center, Family Clinic, Moscow, RUS.
Hesham M ShaafalNeurological Surgery, Peoples' Friendship University of Russia (RUDN University) Named After Patrice Lumumba, Moscow, RUS.
Karina Familia RamirezNeurological Surgery, Peoples' Friendship University of Russia (RUDN University) Named After Patrice Lumumba, Moscow, RUS.
Peoples' Friendship University of Russia · RU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background Same-level recurrent disc herniation remains a challenge in spine surgery. Although most surgeons agree on discectomy as the treatment of choice for primary lumbar disc herniation, the management of recurrent disc herniation remains ambiguous and largely depends on the operating surgeon. Many surgeons recommend repeat discectomy over fusion because it is cheaper and less invasive. In this study, we analyzed 50 patients who underwent a repeat discectomy. Materials and methods The patients in the study had previously been managed for lumbar disc herniation and then presented with either recurrent same-level herniation or symptoms attributed to the same level. The patients were then managed with a repeat discectomy without fusion. We analyzed the preoperative and postoperative Oswestry Disability Index (ODI), duration of surgery, blood loss, duration of hospitalization, and complications. Results Fifty patients were included: 27 females (54%), and 23 males (46%). They were followed up for an average of 2.81 years (range: 1-4). The mean duration of hospitalization was 4.06 ± 1.5 days (range: 2-8). The operative time was 104.60 minutes (range: 50-195), with an intraoperative blood loss of 85.40 mL (range: 50-150 mL). Durotomy occurred as a complication in eight (16%) patients. The recurrence rate was 26%, with 36% progressing to fusion. The change in preoperative ODI and postoperative ODI was 20.94 ± 7.24 (6-37), with a p-value of 0.04. There were no long-term complications recorded. Conclusion Repeat discectomy is a good management option for same-level recurrent disc herniation. The procedure is associated with low intraoperative blood loss and a short operating time, but there is a significant risk of durotomy. The risk of recurrence remains a concern due to the progression of degenerative changes, especially in the presence of Modic-2 changes. These advantages and disadvantages should be discussed with patients.

Indexed as

degenerative disc diseasediscectomymodic changesoswestry disability index (odi)recurrent lumbar disc herniationspinal instability

Identifiers

PMID37456489
PMCPMC10349588
OpenAlexW4380995469

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.