The recurrence of pain following operation for herniated lumbar disc: fresh herniation or extradural scar tissue?
The clinical findings, the appearance of the myelogram and the findings at re-operation are described in 34 patients who had persistent or recurrent pain following operation for removal of a herniated lumbar disc. An attempt was made to distinguish before re-operation whether the residue symptoms were due to recurrence of, or a fresh disc herniation, or to extradural scarring. Persistence of pain after the initial operation or the time interval before pain re-appeared did not help to distinguish the causative pathology. A recurrent disc herniation was found if a different disc was involved, but was else best distinguished by myelographic demonstration of a short indentation in the contrast column at the level of a disc or a short root sleeve with a thickened associated nerve root. An absence of indentation in the column suggested extradural scarring. At re-operation disc herniation and extradural scarring without herniation were found in approximately equal numbers of patients.
D002921:Cicatrix / Q000150:complications; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology*; D011859:Radiography; D012008:Recurrence; D013126:Spinal Nerve Roots / Q000000981:diagnostic imaging