Clinical analysis of salvage surgery after lumbar disc herniation surgery

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  • 腰椎椎間板ヘルニア摘出術後の同一高位再発に対する手術例についての検討
  • ヨウツイ ツイカンバン ヘルニア テキシュツ ジュツゴ ノ ドウイツ コウイ サイハツ ニ タイスル シュジュツレイ ニ ツイテ ノ ケントウ

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We analyzed forty-nine patients who were operated on for recurrent lumbar disc herniation. 27 patients underwent primary surgery in the other hospitals and 22 in our hospital. The period from primary surgery to revision ranged from 7 days to 11 years. 42 patients were operated on by herniotomy while another 7 were performed additional posterolateral spinal fusion with herniotomy. Average JOA scores before salvage surgery in patients with and without posterior fusion were 11.0 and 10.5 points, respectively. Postoperative JOA score improved to 24.5 and 25.0 points on an average, respectively. In patients with spinal fusion, neither obvious adjacent segment morbidity nor pseudarthrosis have been experienced. The clinical results of re-herniotomy for recurrent lumbar disc herniation were satisfactory and might be the principle method. However, especially in cases with repetitive recurrence of herniation and/or spinal instabilities including the iatrogenic posterior element insufficiencies due to exposure in the salvage surgeries, additional spinal fusion with herniotomy would be advocated.

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