Objective There is a great deal of variability after lumbar discectomy with regard to recurrence rates and outcomes of surgical treatment. Although surgical treatment of lumbar disc herniation is successful in the majority of patients, there are some patients with suboptimal results after discectomy, such as recurrence and exacerbation of back and/or sciatica. However, a small number of cases present with recurrence after a period of symptomatic relief, and the majority of patients with recurrence require reoperative treatment. This article retrospectively examines the analysis of clinical outcomes and prognostic factors in the surgical treatment of recurrent disc herniation. Methods From January 2006 to mid-October 2008, a total of 23 cases qualified for recurrent lumbar disc herniation (more than 6 months after the first surgery and occurring in the same section) and underwent reoperation in our hospital. The main symptoms were low back pain, radiating pain, numbness, muscle atrophy and weakness of the affected limbs. Physical examination was mostly positive for straight leg raising test, with abnormal sensory and motor functions and tendon reflexes in the corresponding nerve distribution area. Disc herniation was confirmed by MRI and/or CT, and lumbar spine stability was detected by lumbar dynamic position film. Re-operation is decided by posterior laminar decompression, nucleus pulposus removal, arch root internal fixation + laminar or intertransverse bone graft depending on lumbar stability evaluation, secondary spinal stenosis, etc. In general, patients who require subtotal arthrodesis, are at risk for postoperative medically induced instability, or have preoperative intervertebral instability require both posterior posterolateral fusion and transpedicular pedicle screw fixation. The disc nucleus pulposus tissue removed intraoperatively was routinely sent for pathological examination in all patients to determine whether it was recurrent herniated nucleus pulposus tissue. Straight leg raising exercises were started on the third postoperative day to prevent nerve root adhesions, and lumbar muscle rehabilitation was performed 7 days later. The MacNab score was used postoperatively to assess work capacity after spinal surgery. Satisfaction was graded as excellent, good, fair or poor. Results Twenty-three patients were reoperated and all were found to have varying degrees of adhesions at the original surgical site during surgery. Five patients had intraoperative dural tears due to severe scar adhesions, which were repaired intraoperatively, and no postoperative cerebrospinal fluid leak occurred. 23 patients were followed up for 6 to 40 months, with a mean of 20.4 months. Based on MacNab criteria, 19 patients (82.6%) had an excellent prognosis. No loosening or fracture of the internal fixation and fusion of the implant were observed at imaging follow-up. Postoperative pathological findings in all patients showed intervertebral disc nucleus pulposus tissue. Discussion Recurrent lumbar disc herniation is defined as symptomatic relief after lumbar disc removal for at least 6 months, followed by recurrent disc herniation in the same segment ipsilateral or contralateral to the disc. The cause of recurrent lumbar disc herniation after surgery may be related to incomplete removal of the nucleus pulposus during surgery. There are multiple risk factors for recurrent disc herniation, such as progressive degeneration at the surgical site and degeneration of adjacent segments, structural weakness of the fibrous annulus tissue, exposure to repetitive weight-bearing and repetitive vibration environments, and smoking. Male patients with significant disc degeneration are most likely to develop recurrent disc herniation, especially after an isolated trauma or exertion. We believe that for recurrent lumbar disc herniation with significant symptoms, complete surgical decompression and removal of the residual disc should be performed. In cases with lumbar instability and possible postoperative instability, internal fixation with pedicle screws and fusion with bone graft were given, and more satisfactory results were achieved in the postoperative follow-up.