Objective
The range of reoperation after lumbar disc surgery from 5 to 20%, and the rate of success after repeated operation varies from 12 to 82%. We designed this study to analyze the cause of reoperation in the lumbar disc herniation after primary operation, to evaluate the risk factor and to suggest the rational approaches preventing and solving the problems related with reoperation.
Methods
We retrospectively reviewed the 64 reoperated patients who had recurrent pain or neurologic aggravation, showing abnormal CT or MRI findings. The evaluation of clinical outcome was assessed according toProlo's scale. We analyzed the factor that affecting surgical outcome.
Results
According to Prolo's scale, good surgical outcome was detected in 34 cases(52%), moderate in 18(28%), and poor outcome was detected in 13 cases(20%). The best outcome was achieved in patients with recurrent disc hernation. On the other hand, Epidural fibrosis and foraminal stenosis were related in poor outcome.
Conclusion
It is concluded that epidural fibrosis and foraminal stenosis are most important causes of poor clinical outcome. This fact suggests careful preoperative workup and meticulous surgicalmanipulation in revision surgery.
