[Reoperative treatment of lumbar disc herniation].

OBJECTIVE

To explore the causes, methods and outcomes of reoperative treatment after lumbar disc surgery.

METHODS

Nine hundred and twenty eight patients with lumbar disc herniation were treated surgically from January 1995 to January 2004, of whom 43 patients (4.6%) underwent reoperation due to persistent pain or recurrence of symptoms. Forty patients were followed up from 3 months to 84 months (mean 30 months).

RESULTS

According to Macnab's criteria, outcomes were excellent in 11 cases (27.5%), good in 16 cases (40%), fair in 8 cases (20%), and poor in 5 cases (12.5%).

CONCLUSIONS

The major causes of reoperation after lumbar disc surgery included incomplete removal of herniating discs and recurrent disc herniation of primary interspace, secondary lumbar canal stenosis, and adhesion of nerve roots. Prior to primary surgical treatment of lumbar disc herniation, operative indications must be strictly accurate, surgical methods should be correctly selected, and improved and refined surgical skills should be guaranteed. Satisfactory outcomes can be gained with reoperation for patients who still requiring treatment.