OBJECTIVE: It remains unknown whether @entity146 or limited removal of disc fragment alone with little disc invasion provides a better outcome for the treatment of @entity890 with @entity614 . We reviewed the literature to determine whether outcomes reported after limited discectomy ( @entity2649 ) differed from those reported after @entity146 ( @entity146 ) with regard to long-term back @entity158 or recurrent disc herniation. METHODS: A systematic MEDLINE search was performed to identify all studies published between 1980 and 2007 reporting outcomes after @entity146 or @entity2649 for a @entity890 with @entity614 . The incidence of short- and long-term recurrent back or @entity158 and recurrent disc herniation was assessed from each reported @entity2649 or @entity146 cohort and the cumulative incidence compared. RESULTS: Fifty-four studies (60 discectomy cohorts) met the inclusion criteria, reporting the outcomes of 13 359 @entity1 after @entity2649 ( @entity2649 , 6135 @entity1 ; @entity146 , 7224 @entity1 ). The reported incidence of short-term recurrent back or @entity158 was similar after @entity2649 (mean, 14.5%; range, 7-16%) and @entity146 (mean, 14.1%; range, 6-43%) (P < 0.01). However, more than 2 years after surgery, the reported incidence of recurrent back or @entity158 was 2.5-fold less after @entity2649 (mean, 11.6%; range, 7-16%) compared with @entity146 (mean, 27.8%; range, 19-37%) (P < 0.0001). The reported incidence of recurrent disc herniation after @entity2649 (mean, 7%; range, 2-18%) was greater than that reported after @entity146 (mean, 3.5%; range, 0-9.5%) (P < 0.0001). CONCLUSION: Review of the literature demonstrates a greater reported incidence of long-term recurrent back and @entity158 after @entity146 but a greater reported incidence of recurrent disc herniation after @entity2649 . Prospective, randomized trials are needed to firmly assess this possible difference.

Recurrent disc herniation and long-term back pain after primary XXXX : review of outcomes reported for limited versus aggressive disc removal.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity146 :: ('MESH:D001523', 'Disease') :: ['aggressive discectomy', 'AD', 'aggressive disc removal with curettage'] @entity2649 :: ('MESH:C563613', 'Disease') :: ['LD', 'lumbar discectomy'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain', 'leg pain'] @entity614 :: ('MESH:D011843', 'Disease') :: ['radiculopathy'] @entity890 :: ('MESH:D007405', 'Disease') :: ['lumbar disc herniation', 'herniated lumbar disc']
@entity2649 :: (MESH:C563613,Disease) :: ['lumbar discectomy']
