REPEAT DECOMPRESSION OF LUMBAR NERVE ROOTS - A PROSPECTIVE 2-YEAR EVALUATION

In a prospective, consecutive study 93 patients who had had previous l umbar spinal surgery underwent repeat decompression for persistent or recurrent back and leg pain. The previous operations had been discecto mies in 65 patients and decompression for spinal stenosis in 28; two o f the latter group had also had posterolateral fusion. At the repeat o peration, disc herniation was found in 19 patients, lateral spinal ste nosis in 19, central spinal stenosis in 20 and periradicular fibrosis in 35. Ninety-one patients were followed up for two years after surger y; the effect of the operation was recorded using a four-scale grading system. The results were significantly related to the diagnosis. Nerv e-root compression due to recurrent disc herniation or to bony compres sion responded well to repeat decompression. In patients with a single nerve-root compression the results were similar to those obtained in primary operations. Sciatica due to nerve-root scarring was seldom imp roved by the repeat operation.