Long term follow-up after second lumbar disc surgery: 10-years experience

G. Spanu, F. Tartara, F. Tancioni, E. Dalla Toffola, S. Ricotti, L. Infuso

Research output: Contribution to journalArticle

Abstract

In this retrospective study, 50 patients suffering from persistent or recurrent low back and/or leg pain after lumbar discectomy, without spinal instability, and which underwent a second surgical procedure were analysed (40 cases at the same level: group I; 10 cases at different levels: group II). Analysis of operative findings showed presence of recurrent disc herniation or residual disc fragments alone in 15 patients (30%), retained disc fragments associated with fibrosis in 22 (44%) and prevalence of epidural scarring in 13 (26%). Surgical results are as follow: in the first group 25 patients (62.5%) had a good outcome, 10 (25%) unchanged status and 5 (12.5%) worsened; in the second group 8 patients (80%) had a good outcome, 2 (20%) unchanged status and none worsened. Totally 33 patients (66%) had clinical improvement, 12 (24%) were unchanged and 5 (10%) worsened. The functional recovery of the lumbar spine (stated as mobility), considering all patients was good in 78% of the cases (31 patients in first group and 8 in second group) and poor in 22% (9 patients in first group and 2 second group). A substantial reduction in the degree of the physiological lordosis was seen and recorded in 96% of the all patients, despite 88% of patients who completely recovered the work capacity and 2% who gained only a partial recovery. Results were not related to age, gender and occupation, but were related to the type of underlying lesion, with significant correlation if considered the different groups separately: the patients affected by fibrosis alone did worse than the other groups. The best results were independent from the presence and length of a pain-free interval between the first and the second surgical procedure.

Original languageEnglish
Pages (from-to)47-56
Number of pages10
JournalNeuro-Orthopedics
Volume22
Issue number1
Publication statusPublished - 1998

Keywords

  • Disc herniation
  • Fibrosis
  • Functional evaluation
  • Laminectomy
  • Lumbar spine
  • Recurrence

ASJC Scopus subject areas

  • Surgery
  • Neuroscience(all)

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  • Cite this

    Spanu, G., Tartara, F., Tancioni, F., Dalla Toffola, E., Ricotti, S., & Infuso, L. (1998). Long term follow-up after second lumbar disc surgery: 10-years experience. Neuro-Orthopedics, 22(1), 47-56.