REVISIONAL LUMBAR MICRODISCECTOMY - AN ANALYSIS OF OPERATIVE FINDINGSAND CLINICAL OUTCOME

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.