Major New UK Study Highlights Risks of Post-Surgery Disc Prolapse

Data from one of the world’s largest spine studies identifies reherniation risk factors after prolapsed disc surgery.


Surgical discectomy is an effective treatment for lumbar intervertebral disc herniation, but despite developments in technique the incidence of reoperation is still estimated to be between 13% to 25%. Until now robust predictive metrics and risk factors associated with recurrent lumbar disc herniation haven’t been clearly defined.

The independent study was presented virtually, due to COVID-19 restrictions, at EUROSPINE. an international conference hosted by the Spine Society of Europe. It investigated patient demographics and patient-reported outcome measures including back and leg pain. Postoperative data was also collected from clinical notes and MRI database and the team checked against all imaging providers in the region. Diagnosis was confirmed clinically or by operative findings

Collected over a 10-year period, the study analysed the reoccurrence and risk factors of prolapsed disc post-surgery. Results from 888 lumbar discectomy patients who all had a minimum of two years follow-up, revealed that the female sex, smoking, and having a higher pre-operation disability were all factors for reherniation. 

The research was carried out by Spinal Consultant Mr Am Rai and his colleagues from the Department of Orthopaedics and Spinal Surgery at the Spire Norwich Hospital and Norfolk and Norwich University Hospital. The presentation was made under the London Norwich Spine Clinic name, a clinic founded by Mr Rai in 2003 to give patients with spinal conditions access to the best surgical care.

Headquartered in Norwich, and with state-of-the-art facilities in London, the clinic specialises in treating a wide range of problems, including disc herniations in the neck and lower back, spinal deformities such as scoliosis and kyphosis in adults and children, plus trauma, infections and tumours.

Investigator comments

Mr Rai explains: “The rate of reherniation after lumbar discectomy varies widely and the role of risk factors has not been fully established. Equally, among clinicians, the subsequent treatment option in the management of symptomatic recurrent lumbar disc herniation remains unclear.

“The aim of the study was therefore to identify the true incidence and the associated risk factors. It is the largest one of its kind and the findings are important for healthcare practitioners globally when developing management strategies.”

Source: The London Norwich Spine Clinic

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