The reported results for primary lumbar disc surgery in open standard technique are succesful in 80–95% of patients, while after repeated surgery range from 28 to 81%. The best clinical results occur when there is an indication of neurological impairment, nerve root compression and radiological confirmation. We report the results of a retrospective study on 54 patients, aged 30 – 65 years, who were presented with recurrence of symptoms and operated on for a 2nd or 3rd time after a previous discectomy, between the period 1990 to 2001.
The preoperative findings for the revision surgery were: Radiculopathy secondary to a new herniation, 14 patients. Due to recurrent disc prolapse at the same level, 9 patients. Due to lateral recess stenosis, 12 patients. Instability secondary to a previous wide laminectomy, 4 patients. No obvious cause, probably due to fibrosis, 5 patients. Multiple root syndrome due to a tumor, 1 patient. Cauda equina syndrome due to an hematoma 1 patient. The follow-up of the patients ranges between 1–12 years and the results of the revision surgery are classified according to Finnegan’s classification.
Forty-six patients rated the revision surgery worthwhile (85%).
Relief of pain more than 6 months after the previous surgery. Sciatica >
Low back pain. Nerve root compression from a new herniation in another level or recurrence at the same. Lateral recess stenosis. Good correlation of the clinical and radiological findings. The factors with bad prediction were The intra-operative fibrosis. Pain relief less than 6 months The bad psychological condition of the patients.
