Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Reasons for failure of L5-S1 intervertebral disc excisions

  • 32 Accesses

  • 6 Citations


This study reviews 247 patients who still had preoperative complaints six months to two years after disc excision. In over half, spondylosis of the L5-S1 facets was present, concurrently associated with a pelvic obliquity. A number of other organic causitive factors were identified in 18% of the patients. Nonorganic reasons accounted for failure in only 13%. Over 70% of patients with associated spondylosis were improved by treatment directed at this condition.


Cette étude concerne 247 patients qui continuaient à souffrir six mois à deux ans après ablation d'une hernie discale. Plus de la moitié d'entre eux présentaient une arthrose des articulations intervertébrales postérieures L5-S1, habituellement associée à une obliquité du bassin. D'autres causes organiques furent mises en évidence chez 18% des patients. L'échec n'était dû à une cause inorganique que dans 13% des cas. Plus de 70% des patients présentant une arthrose des articulaires postérieures furent améliorés par le traitement de cette affection.

This is a preview of subscription content, log in to check access.


  1. 1.

    Barr JS, Riseborough EJ, Freeman PA (1963) Failed surgery for low-back and sciatic pain. J Bone Joint Surg [Am] 45: 1553

  2. 2.

    Beals RK, Hickman NW (1972) Industrial injuries of the back and extremities. J Bone Joint Surg [Am] 54: 1593–1611

  3. 3.

    Blitz DM, Ford LT (1977) An evaluation of narrowing following intradiskal injection of chymopapain. Clin Orthop 129: 191–195

  4. 4.

    Bradford DS, Cooper KM, Oegema TR (1983) Chymopapain, chemonucleolysis, and nucleus pulposus regeneration. J Bone Joint Surg [Am] 65: 1220–1231

  5. 5.

    Burton CV, Kirkaldy-Willis WH, Yong-Hing K, Heithoff KB (1981) Causes of failure of surgery on the lumbar spine. Clin Orthop 157: 191–199

  6. 6.

    Campbell E, Whitfield RD (1947) Certain reasons for failure following disk operations. NY State J Med 47: 2569–2572

  7. 7.

    Crock HV (1976) Observations on the management of failed spinal operations. J Bone Joint Surg [Br] 58: 193–199

  8. 8.

    Finnegan WJ, Fenlin JM, Marvel JP, Nardini RJ, Rothman RH (1979) Results of surgical intervention in the symptomatic multiply-operated back patient. J Bone Joint Surg [Am] 61: 10777–1081

  9. 9.

    Finnegan W, Rothman RH, Fenlin JM, Marvel JP, Nardini RJ (1975) Salvage spine surgery. J Bone Joint Surg [Am] 57: 1034

  10. 10.

    Firooznia H, Benjamin V, Kricheff II, Rafii M, Golimbu C (1984) CT of lumbar spine disk herniation: Correlation with surgical findings. AJR 142: 587–592

  11. 11.

    Frymoyer JW, Newberg A, Pope MH, Wilder DG, Clements J, MacPherson B (1984) Spine radiographs in patients with low-back pain. J Bone Joint Surg [Am] 66: 1048–1055

  12. 12.

    Ghormley RK (1933) Low back pain. JAMA 101: 1773–1777

  13. 13.

    Greenwood J, McGuire TH, Kimball F (1952) A study of the causes of failure in the herniated intervertebral disc operation. J Neurosurgery 9: 15–20

  14. 14.

    Hakelius A (1970) Prognosis in sciatica. A clinical follow-up of surgical and non-surgical treatment. Acta Orthop Scand (Suppl 129)

  15. 15.

    Hall H (1983) Examination of the patient with low back pain. Bull Rheum Dis 33: 1–8

  16. 16.

    Henderson RS (1952) The treatment of lumbar intervertebral disc protusion. Br Med J 2: 597

  17. 17.

    Horal J (1969) The clinical appearance of low back disorders in the city of Gothenburg, Sweden. Acta Orthop Scand [Suppl 118]

  18. 18.

    Jochheim KA, Loew F, Rutt A (1961) Lumbaler Bandscheibenvorfall. Springer, Berlin, Göttingen, Heidelberg

  19. 19.

    Kirkaldy-Willis WH, Hill RJ (1979) A more precise diagnosis for low-back pain. Spine 4: 102–109

  20. 20.

    Mooney V, and Robertson J (1976) The facet syndrome. Clin Orthop 115: 149–156

  21. 21.

    Nachemson AL (1976) The lumbar spine: An orthopaedic challenge. Spine 1: 59–71

  22. 22.

    Nachlas MD (1952) End-result study of the treatment of herniated nucleus pulposus by excision with fusion and without fusion. J Bone Joint Surg [Am] 34: 981–988

  23. 23.

    O'Connell JEA (1951) Protrusions of the lumbar intervertebral discs. J Bone Joint Surg [Br] 33: 8–30

  24. 24.

    Pedersen HE, Blunch CFJ, Gardner E (1956) The anatomy of lumbosacral posterior rami and meningeal branches of spinal nerves (sinu-vertebral nerves). J Bone Joint Surg [Am] 38: 377

  25. 25.

    Pheasant HC, Dyck P (1982) Failed lumbar disc surgery Cause, assessment, treatment. Clin Orthop 164: 93–109

  26. 26.

    Salenius P, Laurent LE (1977) Results of operative treatment of lumbar disc herniation. Acta Orthop Scand 48: 630–634

  27. 27.

    Shealy CN (1972) Facet denervation in the management of back and sciatic pain. Clin Orthop 115: 157–164

  28. 28.

    Spangfort EV (1972) The lumbar disc herniation. Acta Orthop Scand [Suppl 142]

  29. 29.

    Southwick SM, White AA (1983) The use of psychological tests in the evaluation of low-back pain. J Bone Joint Surg [Am] 65: 560–565

  30. 30.

    Stauffer RN, Coventry MB (1971) A rational approach to failures of lumbar disc surgery: The orthopedist's approach. Orthop Clin North Am 2: 533–542

  31. 31.

    Surin VV (1977) Duration of disability following lumbar disc surgery. Acta Orthop Scand 48: 466–471

  32. 32.

    Waddell G, Kummel EG, Lotto WN, Graham JD, Hall H, McCulloch JA (1979) Failed lumbar disc surgery and repeat surgery following industrial injuries. J Bone Joint Surg [Am] 61: 201–207

  33. 33.

    Weber H (1975) The effect of delayed disc surgery on muscular paresis. Acta Orthop Scand 46: 631–642

  34. 34.

    White AW, Gordon SL (1982) Synopsis: Workshop on idiopathic low-back pain. Spine 7: 141–149

  35. 35.

    Wiltse LL, Rocchio PD (1975) Preoperative psychological tests as predictors of success of chemonucleolysis in the treatment of the low-back syndrome. J Bone Joint Surg [Am] 57: 478–483

Download references

Author information

Correspondence to E. L. Radin.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Radin, E.L. Reasons for failure of L5-S1 intervertebral disc excisions. International Orthopaedics 11, 255–259 (1987). https://doi.org/10.1007/BF00271458

Download citation

Key words

  • Low back pain
  • Spondylosis
  • Disc excision
  • Intervertebral facet syndrome
  • Ruptured intervertebral disc