The study on the causes and reoperative treatment of failed back surgery syndrome

Objective To analyze the causes for herniation of lucmbardisc operation and explore the methods,outcomes of reoperative treatment.Methods The clilical data from 38 patients from January 2006 to January 2010 were retrospectively analyzed.All the cases were reoperated including 16 cases did laminectomy or enlarged laminectomy,10 cases did semi-laminectomy,7 cases did total laminectomy,5 cases did total laminectomy and pedicle screw fixation and bone graft fusion.Results All the cases were followed up for 6 months to 3 years with the average of 1 year and 3 months.According to the Macnab standard,the excellent and good rate was 94.7% with excellent in 27 cases,good in 9 cases,acceptable in 2 cases.Conclusion The main causes for reoperation after lumbar disc surgery include:incomplete removal of herniated nucleus pulposus,neglect of multiple intervertebral space,recurrent disc herniation,wrong intraoperative location,postoperative segmental instability and the coexisting narrow and stenosis of nerve root canal,lateral recess and central spinal canal.Among them the most causes(47.3%)are neglect of lateral recess stenosis and incomplete removal of herniated nucleus pulposus,which should cause close attention.If the methods of reoperation will be choosen suitably,statisfactory outcome can be gained for the patients.