| Findings and outcome of revision lumbar disc surgery. | |
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MedLine Citation:
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PMID: 10451043 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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One hundred fourteen patients (64 men, 50 women) with prior lumbar disc surgery underwent a reexploration for intractable back and/or leg pain. The finding in revision surgery included disc herniation in 89 cases (78%), epidural fibrosis in 14 cases (12.2%), adhesive arachnoiditis in 4 cases (3.5%), isolated lateral spinal stenosis in 3 cases (2.6%), and iatrogenic instability in 4 cases (3.5%). Review of operative reports of patients who underwent a first operation in our institute revealed that seven cases (12.5%) had a second laminotomy without a discectomy in addition to the previous laminotomy and discectomy performed in the same session. Fifty-six of the patients with disc hemiation in revision surgery had a true recurrence. Disc hemiation was protruded in 38 cases (42.8%), extruded in 44 cases (49.4%), and sequestrated in 7 cases (7.8%). The outcome was assessed using Prolo's functional and economic scale. According to Prolo's scale, a good outcome was detected in 79 cases (69.2%), moderate in 22 (19.2%), and a poor outcome was detected in 13 cases (11.4%). The best outcome was achieved in patients with disc hemiation. It is concluded that recurrent disc disease is the most important cause of reexploration. This fact dictates a careful preoperative workup and discectomy in the first intervention. The likelihood of occurrence of disc herniation in the negative laminotomy level (i.e., laminotomy without discectomy procedure) also requires a careful preoperative radiologic workup before lumbar disc surgery. |
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Authors:
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S Ozgen; S Naderi; M M Ozek; M N Pamir |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of spinal disorders Volume: 12 ISSN: 0895-0385 ISO Abbreviation: J Spinal Disord Publication Date: 1999 Aug |
Date Detail:
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Created Date: 1999-10-12 Completed Date: 1999-10-12 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 8904842 Medline TA: J Spinal Disord Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 287-92 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Marmara University, School of Medicine, Istanbul, Turkey. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Arachnoiditis / etiology, surgery Diskectomy* / adverse effects Epidural Space / pathology Female Fibrosis Follow-Up Studies Humans Intervertebral Disk Displacement / surgery* Laminectomy Lumbar Vertebrae / surgery* Male Middle Aged Postoperative Complications / surgery Recurrence Reoperation Retrospective Studies Severity of Illness Index Spinal Stenosis / etiology, surgery Tissue Adhesions / etiology, surgery Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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