[Differential diagnosis and surgical indications in lumbar intervertebral disk recurrence]

This retrospective study concerns 48 patients who underwent reoperation some time after lumbar disc surgery because of persistent or recurring leg pain. During the same period (January 1980 to October 1982) 821 primary lumbar discectomies were done. Surgical findings at reoperation of 48 patients: 30 patients (3%) had a recurrent disc herniation at the previous site, 9 patients (1%) had disc herniations at a new site only, and 9 patients (1%) had only considerable epidural scar formation. The preoperative differentiation between symptoms related to recurrent disc herniation and those related to epidural scar formation is difficult, because in this situation myelography can not be relied upon. In our series of 48 patients, myelography showed in 27% of the cases false positive or false negative results. The clinical signs and symptoms are therefore of paramount importance.