Decompression laminectomy and lateral spinal fusion in patients with previously failed lumbar spine surgery.
Sixty-two patients who had had previous failed lumbar disk surgery (average 1.4 surgeries) were treated with a decompression laminectomy and lateral spinal fusion. Follow up averaged 4.2 years and results were based on pain relief, improved function, and return to work as recorded on a patient questionnaire. Using a scoring system to quantify the change from the patients felt the surgery was very worthwhile, 32% had a good result, 29% had a fair result, and 38% had a poor result. However, 53% of the patients felt the surgery was very worthwhile, 37% rated it somewhat worthwhile, and 10% responded that the surgery was not worthwhile. Factors which statistically correlated with a higher improvement score were the presence of a unilateral radicular pain pattern, a year pain free interval since the previous surgery, and a myelogram which was more indicative of a disk herniation rather than cicatrix formation. Similarly, those patients who were found to have a recurrent or new disk at the time of surgery did better than those whose major finding was scar formation. The quality of the fusion mass was positively correlated with a better final result with questionable statistical significance (P = .06). Finally, those patients who were industrial improved much less and only 14% returned to work as compared to 61% of the non-industrial patients.
Quimjian
J D
JD
Department of Orthopedics, Mount Carmel Medical Center, Columbus, Ohio.
Matrka
P J
PJ
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery*; D007796:Laminectomy; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012086:Reoperation; D013122:Spinal Diseases / Q000601:surgery; D013123:Spinal Fusion