Reasons for failure of L5-S1 intervertebral disc excisions

International Orthopaedics volume 11, pages255–259(1987)Cite this article

Summary

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.

Résumé

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.

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References

  1. 1.

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

    Google Scholar 

  2. 2.

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

    Google Scholar 

  3. 3.

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

    Google Scholar 

  4. 4.

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

    Google Scholar 

  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

    Google Scholar 

  6. 6.

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

    Google Scholar 

  7. 7.

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

    Google Scholar 

  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

    Google Scholar 

  9. 9.

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

    Google Scholar 

  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

    Google Scholar 

  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

    Google Scholar 

  12. 12.

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

    Google Scholar 

  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

    Google Scholar 

  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

    Google Scholar 

  16. 16.

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

    Google Scholar 

  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

    Google Scholar 

  19. 19.

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

    Google Scholar 

  20. 20.

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

    Google Scholar 

  21. 21.

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

    Google Scholar 

  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

    Google Scholar 

  23. 23.

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

    Google Scholar 

  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

    Google Scholar 

  25. 25.

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

    Google Scholar 

  26. 26.

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

    Google Scholar 

  27. 27.

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

    Google Scholar 

  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

    Google Scholar 

  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

    Google Scholar 

  31. 31.

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

    Google Scholar 

  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

    Google Scholar 

  33. 33.

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

    Google Scholar 

  34. 34.

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

    Google Scholar 

  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

    Google Scholar 

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  1. Department of Orthopedic Surgery West Virginia University Medical Center, 26506, Morgantown, WV, USA

    E. L. Radin

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  1. E. L. Radin
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Correspondence to E. L. Radin.

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

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Key words

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