[Long-term results in revision surgery following lumbar disk nucleotomy]]

In 6.26% of 846 patients with lumbar disc surgery a reoperation was necessary. A total of 93 patient had undergone a revision surgery inclusive a patient group with primary surgery performed elsewhere. 68 patient had 1 reoperation, 22 patients 2, 2 patients 3, and one patient had even 4 revisions. Follow-up ranged between 19 and 42 years with an average of 31 years. 53 patients were clinically examined at a time of follow up and another 15 patients answered a questionnaire. An excellent result with no complaints and patients able to work could be achieved in only 16%. A good result with no radicular pain, but some minor back pain and some loss of sensibility and ability to work was found in 24%. In 40% of the patients the result was only fair with some radicular pain and limited capability for work. 20% of the patients had only a poor result with unchanged symptoms and continued therapy. Those patients were not able to work. Young and female patients had a better prognosis. Another positive predictor was a short period of preoperative pain. Negative predictors were multiple prior operation as well as scar tissue at time of revision. Also spondylodesis according to Cloward correlated also with a negative clinical outcome.