腰椎椎間板ヘルニアの再手術例の検討

Abstract

From 1978 to 1994, we operated on 595 cases of lumbar disc herniation using Love's method alone or in addition to another type of (postero-lateral fusion or other instruments). We report on our analysis of 25 of these 595 cases who reguied reoperation.The average interval between the first and second operaton was 4.8 years.In regard to patients age, those in the re-operated group tended to be more in the 20-39 year old group.In regard to the level of disc herniation, the number of re-operated cases with problems at L4/5 and L5/S1 were similar. In addition, 17 of the re-operated cases were located at the same level as their first operation.In regard to types of herniation (according to Yanagida's classification), there were no diffrences in the numbers of re-operated cases among the 4 types.If fixation was performed at the first operation, there was less likelihood of those cases requiring reoperation compared to non-fixated cases.The amount of nucleus resected at the first operation had no connection with the duration between the first operation and reoperation.In conclusion, there was no relationship between reoperation and disc level of herniation, types of herniation, and amount of nucleus resected.However, fixation at the first operation affected numbers requiring reoperation in this study.