J Korean Soc Spine Surg.  1997 Nov;4(2):329-336.

Multiply Operated Lumbar Spine

• Ha KY
• Kim KW
• Chang CH
• Won JY

Abstract

STUDY DESIGN: A retrospective analysis was performed on 40 patients who had had previous lux bar spine surgeries.
OBJECTIVE
To determine what factors most influenced surgical outcome and to analyze results in a series of revision lumbar surgeries. SUMMARY OF BACKGROUND DATA: Satisfactory surgical outcome of the revision lumbar surgery range from 28% to 82% and are rarely comparable to primary surgery. Many factors predicting outcome from repeat lumbar surgery haute been listed.
METHODS
Forty patients were analyzed who had had previous lumbar surgeries. The patients were classified into 5 groups according to diagnosis: 3 Infection,5 instability,8 nonunion, 14 HNP and 10 spinal stenosis. of 40 patients,33 patients(82.5%) underwent fusion with instrumentation for repeat surgery. Their clinical course was followed for a minimum of 1 year. The number of surgery on each mpatient was 1.3 times on an average.
RESULTS
Overall, 80% of patients had a satisfactory result. Obviously extruded or sequestrated HNP in MRI findings, complete block of contrast with severe radiculopathy and/or myelopathy in spinal stenosis, complete decompression, neurolysi s and fusion with instrumentation, and longer than 6 month pain relief after precious surgery were correlated with satisfactory outcome. However, the number of precious operation, age, repair of pseudarthrosis , no abnormality at surgery and combined multiple degenerative joint disease were significantly correlated with poor surgical outcome. The most common complication during repeat surgery was dural tear in 5 cases(12.5%).
CONCLUSIONS
Success rate of revision surgery was low as compared to primary operation. Therefore, erroneous diagnosis and faulty surgical technique understandably lead to failure, and precise attention to preoperative and intraoperative detail can minimize these sources of error.

MeSH Terms

Decompression
Diagnosis
Humans
Joint Diseases
Magnetic Resonance Imaging
Pseudarthrosis
Radiculopathy
Reoperation
Retrospective Studies
Spinal Cord Diseases
Spinal Stenosis
Spine*
Tears