| Clinical Analysis of Prognostic Factors of Reoperation after Degenerative Lumbar Disc Surgery |
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Hwang-Hwi Kim, M.D., Young-Joon Kwon, M.D., You-Sam Won, M.D., Jae-Young Yang, M.D., Chun-Sik Choi M.D. |
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Department of Neurosurgery, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea |
| 재수술을 시행한 요추부 퇴행성 디스크질환자의 예후 인자에 관한 분석 |
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김황휘,권영준,원유삼,양재영,최천식 |
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성균관대학교 의과대학 강북삼성병원 신경외과학교실 |
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| Abstract |
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. |
| Keywords:
Reoperation.Recurrent HNP.Epidural fibrosis.Foraminal stenosis |
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