Repeat lumbar spine surgery. Factors influencing outcome.
Forty-five patients who had residual symptoms after lumbar spine surgery were re-evaluated and underwent additional surgery. After a minimum of 2 years' follow-up, these patients' results were reviewed to determine what variables might predict long-term outcome. Age, number of previous operations, and psychological diagnosis were not statistically significant, but a non-compensable injury, ability to return to work after surgery, a negative history of litigation, and achieving a solid fusion were statistically significant in predicting a good outcome. In this study of 45 patients who had repeat surgery, 82% were improved at an average follow-up of 28.2 months. Intrathecally enhanced computed tomography, magnetic resonance imaging, discography, and computed tomography-discography are required to thoroughly evaluate the previously operated lumbar spine, because a single imaging study showed surgical abnormalities in only 61% of the patients in this study.
Bernard
T N
TN
Hughston Clinic, Columbus, Georgia.
D003952:Diagnostic Imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000453:epidemiology / Q000601:surgery*; D017116:Low Back Pain / Q000453:epidemiology; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011581:Psychological Tests; D012008:Recurrence; D012086:Reoperation; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome