Failed lumbar spinal surgery

Dhar, Sanjay; Porter, Richard W.

doi:10.1007/bf00180207

Cited by 7 publications

(2 citation statements)

References 29 publications

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“…Dhar et al have suggested that the commonest cause of failure is incorrect assessment and selection for operation and stress the importance of psychological testing and analysis of any compensation claims [6]. We agree, but wish to emphasise the significance of the indications for operation and the surgical technique.…”

Section: Discussionmentioning

confidence: 88%

Revision surgery for lumbar disc herniation

Baba

Chen

Kamitani

et al. 1995

International Orthopaedics

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We reviewed 45 patients who had undergone repeated open operations for lumbar disc herniation. There were 26 men and 19 women with a mean follow up of 4.3 years. Twenty-fourpatients had had one previous discectomy, 12 had 2, and 9 had 3 or more; 11 needed a fusion without instrumentation. Residual or re-extruded disc hernias, either sub-or transligamentous, were frequently found at revision. Good to excellent results were obtained in 64%. Those who had a first-time revision had earlier improvement and better results. Complete removal and a thorough search for herniated disc material is essential when carrying out the initial operation for extruded or sequestrated herniation. At revision, removal of as much as possible of the remaining nucleus and annulus, but with minimal invasion of the posterior elements, is crucial for improving the outcome. R~sumfi. Notre dtude porte sur 45 patients ayant subi ~t plusieurs reprises une discectomie lombaire. Ce groupe itait composd de 26 hommes et de 19 femmes suivis pendant 4,3 ansen moyenne (de 1 gt 8 ans). Vingt-quatre patients avaient ddjit dt~ operas une fois, 12 deux fois et 9 trois fois ou plus. Une arthrodbse dtait indiqu~e dans 11 cas. Les rdinterventions ont montri que des hernies rdsiduelles ou ri-expulsdes, sous-ligamentaires ou trans-ligamentaires, dtaient souvent retrouvdes. 64% (29/45) des patients ont eu de bons ou d'excellents rdsultats. Les patients n 'ayant subi qu' une seule rdintervention se sont rdtablis plus rapidement et ont prdsent~ de meilleurs r~sultats. Nous tenons ~ souligner qu 'iI est essentiel de procider gz Reprint requests to: H. Baba l'ablation complkte et ~ la recherche mdticuleuse de tousles mat~riaux discaux hernids lors de la premikre intervention, en particulier pour les hernies expuls~es ou siquestrYes. En cas de r~in-tervention il convient d'enlever autant d'anneau et de noyau rdsiduel que possible, quoique plus moddrdment en arrikre, pour obtenir les meilleurs rdsultats.

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Section: Discussionmentioning

confidence: 88%

Revision surgery for lumbar disc herniation

Baba

Chen

Kamitani

et al. 1995

International Orthopaedics

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“…A well studied group consisted of failures and poor results in 160 patients after lumbar spinal surgery between 1980 and 1984; they were analyzed retrospectively. 11 A self-rated questionnaire carried out 12 months after operation revealed 20 (12.5%) poor results. These occurred most commonly after multiple operations, or decompression and fusion as compared to disk excision.…”

Section: Operative Treatmentmentioning

confidence: 99%

Aspects of the failed back syndrome: role of litigation

Pearce

2000

Spinal Cord

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Objective: A review that attempts to identify the mechanism and causation of persistent or recurring low back pain. Design: A personal assessment of clinical features with a selective review of the literature. Results: Thirty to forty per cent of our population aged 10 ± 65 years report that back trouble occurs on a monthly basis and in 1% to 8% this interferes with work. A de®nite patho-anatomical cause for the pain is demonstrable in only a minority. It can be deduced that psychosocial factors, including insurance bene®ts are of importance for this variation. Conclusions: Neither non-operative nor surgical procedures have a major impact on the capacity for work in this substantial minority of backache su erers. The main risk factors identi®ed are: Wrong diagnosis, repeated medical certi®cates for sickness bene®ts, failed surgery, symptoms incongruous with signs or imaging, multiple spinal procedures, poor social support and poor motivation, psychological illness, clinical depression before or after injury or operation. Pending compensation and delays in settlement are important additional features in claimants for compensation. For patients with unproven diagnostic labels such as`painbehaviour', no evidence exists that any type of surgery is cost e ective.

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A Review of the Significance, Indications, Techniques, and Outcomes of Revision Lumbar Laminectomy Surgery

Hulen

2008

Seminars in Spine Surgery

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Failed lumbar spinal surgery

Cited by 7 publications

References 29 publications

Revision surgery for lumbar disc herniation

Revision surgery for lumbar disc herniation

Aspects of the failed back syndrome: role of litigation

A Review of the Significance, Indications, Techniques, and Outcomes of Revision Lumbar Laminectomy Surgery

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