Clinical analysis of reoperative treatment of lumbar disc herniation

Abstract

Objective To analyze the reasons and investigate the methods of reoperative treatment after lumbar disc surgery. Methods From May 1999 to March 2007, 37 cases were treated with reoperation after lumbar disc surgery. The reasons were analyzed.Five cases underwent enlarged laminectomy.Six cases did semi-laminectomy.Twenty-six cases did total laminectomy.Twenty-one cases did total laminectomy and transpedicular screw fixation and bone graft (diapophysis fusion for 21cases and interbody fusion for 11 cases simultaneous ). Results The reasons of reoperation included: recurrent lumbar disc herniation(13 cases), adjacent lumbar disc herniation(3 cases), spinal canal stenosis and lateral recess stenosis(11 cases), postoperative segmental instability(7 cases), mistaken implantation of transpedicular screw(2 cases), wrong intraoperative location (1 case). All patients were followed up from 1 year to 7 years (mean 3.2 years). According to macnab's criteria, outcomes were excellent in 11 cases, good in 17 cases, fair in 7 cases and poor in 2 cases. The excellent and good rate was 75.7%. Conclusion Recurrent lumbar disc herniation, postoperative segmental instability, spinal canal stenosis are the main reasons of reoperation. With a correct analysis of reoperative reasons, an appropriate method and fine surgical skills, reoperation can achieve satisfactory result. Key words: Lumbar disc herniation; Reoperation; Recurrence