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Treatment of cervical disc disease using Cloward's technique. Part V. The effect of reoperations
J O Espersen1, A Klaerke, M Buhl
1Department of Neurosurgery, University Hospital, Aarhus, Denmark.
Insights
Reoperation for cervical disc disease after Cloward
Area of Science:
- Neurosurgery
- Spine Surgery
Background:
- Cloward's operation is a common surgical treatment for cervical disc disease.
- Reoperation rates and outcomes following this procedure require further investigation.
Purpose of the Study:
- To evaluate the outcomes of reoperation for cervical disc disease treated with Cloward's procedure.
- To analyze the factors influencing the success of reoperations.
Main Methods:
- Retrospective analysis of 1,106 patients undergoing Cloward's operation over 15 years.
- Focus on 145 patients who required reoperation with a new Cloward procedure.
- Comparison of outcomes based on timing of reoperation (early vs. late) and surgical level.
Main Results:
- Reoperation outcomes were generally poorer than the initial Cloward's operation.
- Early reoperations (due to initial poor results, complications, or graft issues) had poor outcomes.
- Late reoperations (due to relapses) showed results comparable to the first operation.
- Relapse frequency leading to reoperation was 8.8% in the first year, decreasing to 0.2% thereafter.
Conclusions:
- Reoperation for cervical disc disease after Cloward's procedure yields varied results.
- Timing and reason for reoperation significantly impact outcomes.
- Late reoperations for relapses are more successful than early reoperations for other causes.
Abstract:
Among 1,106 patients with cervical disc disease in whom Cloward's operation had been performed over a fifteen-year period, 145 patients were reoperated upon with a new Cloward procedure. In the 1st year after the first operation 3/4 of the patients were operated upon on the previous level, whereas reoperations performed later mainly were done on new levels. The effect of the reoperation was poorer than the effect of the 1st operation. Early reoperations--which were due to: an initially unsatisfactory clinical course, postoperative complications or graft problems--had a poor result, but late reoperations--which were caused by relapses--showed a result corresponding to the first operation. The frequency of relapses leading to a 2nd Cloward operation was 8.8% in the first year falling to 0.2% in the following years of observation.