Document Detail


Findings and outcome of revision lumbar disc surgery.
MedLine Citation:
PMID:  10451043     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
S Ozgen; S Naderi; M M Ozek; M N Pamir
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of spinal disorders     Volume:  12     ISSN:  0895-0385     ISO Abbreviation:  J Spinal Disord     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-10-12     Completed Date:  1999-10-12     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8904842     Medline TA:  J Spinal Disord     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  287-92     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Marmara University, School of Medicine, Istanbul, Turkey.
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MeSH Terms
Descriptor/Qualifier:
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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