Analysis of Reasons for Failure of Surgery for Degenerative Disease of Lumbar Spine.
BACKGROUND
In the aging society, there is a growing number of patients with advanced degenerative disease of the spine. These patients frequently require surgical treatment. This paper aims to analyse the reasons for failure of surgery for degenerative disease of the lumbar spine.


METHODS
Histories of patients operated on by one group of surgeons in the Neuroorthopaedic Department of "STOCER" in 2014 and 2015 due to degenerative disease of the lumbar spine were analysed retrospectively. Out of the cohort, patients who had undergone a revision surgery were selected for the study and divided into two groups: group A (60) of patients previously operated on in another centre and group B (47) of patients previously operated on in "STOCER". The reasons for failure of the surgery were analysed in detail based on history, physical examination, imaging studies and surgery reports.


RESULTS
Surgery was performed in 601 patients, of whom 107 patients had been previously operated on. The most frequent reasons for revision surgery of the same motor segment were recurrent disc herniation, inadequate decompression and inappropriate surgical technique. In the group of patients who had implants inserted to stabilise the spine, the revision surgery in most cases was due to adjacent segment disease.


CONCLUSIONS
Use of implants and spinal fusion is always associated with a risk of complications and is frequently independent of the surgeon. 2. In order to reduce the rate of revision surgeries, it is important to perform complete decompression and select an adequate surgical technique.
Neuroorthopaedic Department , Marian Weiss Memorial Mazovia Rehabilitation Center, Konstancin-Jeziorna, Poland.
Alicja
A
Baranowska
First Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.
Joanna
J
Baranowska
Neuroorthopaedic Department , Marian Weiss Memorial Mazovia Rehabilitation Center, Konstancin-Jeziorna, Poland.
Paweł
P
Baranowski
D000368:Aged; D017586:Diskectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000453:epidemiology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data*; D013123:Spinal Fusion / Q000009:adverse effects*; D013130:Spinal Stenosis / Q000209:etiology