N. Patel et al., REVISIONAL LUMBAR MICRODISCECTOMY - AN ANALYSIS OF OPERATIVE FINDINGSAND CLINICAL OUTCOME, British journal of neurosurgery, 9(6), 1995, pp. 733-737
Forty-one consecutive patients who underwent a revision microlumbar ex
ploration for recurrent or persistent sciatica were reviewed retrospec
tively to analyse the operative findings and assess the clinical outco
me following surgery. Thirty-three (80%) patients were found to have a
recurrent intervertebral disc protrusion at the previous site, two pa
tients had a disc herniation at a new site, one had severe perineural
scarring, two had lateral recess stenosis, one patient had undergone p
revious exploration at an incorrect site and in two patients no cause
for ongoing symptoms was found. Nineteen of the 33 patients with a re-
prolapse presented with persistent or recurrent sciatica within 1 year
of their first operation. The other 14 patients presented with a late
re-prolapse (after 1 year) and their clinical outcome was better than
for those patients with an early re-prolapse (12/14 vs 11/19 satisfac
tory result, respectively). The result of operating on patients with a
late re-prolapse was comparable to the 80-95% satisfactory outcomes f
ollowing primary lumbar microdiscectomy reported by other authors.