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Reoperation after lumbar disc surgery: results in 130 cases
J Fandiño1, C Botana, A Viladrich
1Servicio de Neurocirugía del Hospital General de Vigo, España.
Acta Neurochirurgica
|January 1, 1993
Summary
Re-operation for lumbar disc herniation is successful in 62% of cases. Best outcomes are seen with herniations at other levels or recurrences, while scar tissue alone is less favorable.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Surgery
Background:
- Lumbar disc herniation is a common condition requiring surgical intervention.
- Persistent or recurrent symptoms after initial surgery necessitate re-operation.
- Evaluating the success factors for re-operation is crucial for patient outcomes.
Purpose of the Study:
- To assess the success rate and prognostic factors of re-operation for lumbar disc herniation.
- To compare the diagnostic reliability of Computed Tomography (CT) and Magnetic Resonance Imaging (MR) in re-operation cases.
- To identify contraindications for lumbar disc herniation re-operation.
Main Methods:
- Retrospective analysis of 1850 lumbar disc herniation cases.
- Identification of 130 patients who underwent re-operation.
- Correlation of clinical findings and operative results with imaging modalities (CT and MR).
Main Results:
- Overall re-operation success rate was 62%.
- Excellent results were achieved in 98% for herniations at other levels and 54% for recurrences.
- Scar formation alone yielded only 38% excellent results.
- Magnetic Resonance Imaging (MR) demonstrated higher reliability than Computed Tomography (CT) in differentiating disc prolapse from fibrosis.
Conclusions:
- Re-operation success for lumbar disc herniation depends on operative findings, not clinical presentation.
- Recurrent herniations and herniations at different levels have favorable prognoses.
- Scar tissue alone is a poor indicator for re-operation, and MR imaging is preferred for diagnosis.