A Clinical Analysis of Re-operated Cases of Herniated Intervertebral Disc

The authors experienced 32 cases of reoperation due to persistent or recurred symptoms who had once low back operation due to herniated lumbar disc. The results were summarized as follows: 1) The reoperated cases were most common in 5th decade(31.3% ) and 2nd most common in 4th decade(28.1%) of age, and the male to female ratio was 2:1. 2) The lesion sites of reoperated cases were L4-5 space(68.8%), L5-S1 space(18.8%), multiple space(9.4%) and L3-4 space(3.1%) in orders. 3) The symptom-free interval between 1st and 2nd operation were 1-5 years(34.4%), 6-10 years(15.6%) and 2-6 months(12.5%) in orders. The longest interval were above the 11 years (21.9%) and the shortest interval were below the 1 month(15.6%). 4) The main pathologic findings of reoperated 32 cases were epidural fibrosis(31.2%), incomplete disc removal+epidural fibrosis(31.2%), new disc herniation(21.8%), foraminal stenosis(9.4%) and opposite site herniation(6.3%) in orders. 5) The results of 32 reoperated cases were good(43.7%), excellent(21.8%), fair(18.7%) and poor(15.6%) in orders.

Two Operative Cases of Moya Moya Disease in Children

The treatment of moya moya disease, a chronic occlusive cerebrovascular disease of unknown etiology, isn't settled ut various operative methods to maximize cerebral revascularization have been reported. Two cases in children treated surgically are presented, one with cerebroarteriosynangiosis and the other with encephalo-duro-arterio-synangiosis(EDAS). The methods of cerebral revascularization are discussed in detail.