[Recurrence of sciatica in patients operated on for disk hernia: postoperative segmental spondylosis]

Forty four patients, admitted to the department of of Neurosurgery of the Hospital of Parma, for a recurrence of sciatic pain following discectomy, have been examined between May 1978 and February 1981. In 30 patients myelography was negative for discal hernias, while plain x-ray films and polytomograms of the lumbar spine showed lateral recesses and intervertebral foramina stenosis with roots' compression. The surgical procedures were: medial facetectomy, total facetectomy or hemilaminectomy with removal of pedicle and inferior and superior articular processes, according to the case, obtaining the remission of the pain. We feel that we are dealing with an entrapment syndrome of one or more lumbosacral roots secondary to degenerative spondylotic changes of the lamina-pedicle-facet complex that follows discectomy and is specially located in the same space previously operated upon. We are describing the pathological, clinical and radiological features of this syndrome and the surgical technique used.