Efficacy of repeat discectomy alone versus with spinal fusion in recurrent lumbar disc herniation: a systematic review and meta-analysis of randomized studies.

研究概要

Four randomized controlled trials including 596 patients with recurrent lumbar disc herniation were included in this systematic review and meta-analysis comparing repeat discectomy alone versus discectomy with spinal fusion. Pooled outcomes of interest included low back pain, lower limb pain, disability (JOA score), re-recurrence rate, postoperative instability, and other complications. Fusion significantly reduced low back pain, re-recurrence rate, and postoperative instability, but showed no significant advantage in leg pain or functional disability. The findings suggest that spinal fusion may offer benefits in specific clinical scenarios, especially for patients at high risk of recurrence or instability.