REPEATED OPERATIVE TREATMENT FOR LUMBAR PROLAPSED DISC WITH RECURRENCE OR FAILURE AFTER INITIAL OPERATION / 解放军医学杂志

ABSTRACT

18 out of 779 operated cases for lumbar prolapsed disc at our department were reoperated with excellent or good results obtained in 17 and improvement in 1. 14 out of these were initially treated at our department with satisfactory results for from 2 months to 12 years before symptoms recurred while 4 were first operated upon at other hospitals with good results in 2 and failure for the others after the primary operation. The recurrence rate is 14/779 in our service, i. e. 1.8%, lower than those previously reported.Reoperation for recurrent cases is generally considered extremely difficult and result uncertain because of extensive scar and dense adhesions about the nerve coot and dura. More often than not the results reported in literature were not good enough to warrant reoperation. Consequently those recurrent patients in our series so badly incapacitated would have to suffer or remain crippled for lifetime were they not reoperated. However our patients were salvaged by reoperation with meticulous performance after careful clinical evaluation as to diagnosis, indication and tyfe of operation adopted. Operative procedure for exploration and resolution of coexisting spinal stenosis is discussed in detail.