بررسي موارد عمل جراحي مجدد فتق ديسك در بيمارستان شهداي تبريز و راهكارهاي كاهش آن

Evaluation of Multiple Lumbar Disc Herniation Surgeries at Shohada Hospital in Tabriz and Ways to Prevent Reoperations

Background and Objectives: The majority of patients suffering from a low back pain and/or radiculopathy caused by a herniated nucleus pulposus heal spontaneously without surgery. "[ʹhis leaves only a small percentage of patients with persistent symptoms that are amenable to surgery. One of the techniques for this surgeryʹ is standard discectomv. This may be associated with complications such as recurrent disc herniation, spinal instability, infection, epidural scar formation and arachnoiditis and epidural hematoma, Some of these complications need reoperation. In this paper we reviewed our patients with multiple lumbar spine surgeries after- first standard discectomy. Materials and Methods: From January 1997 to September 2003 we performed 1 1 36 standard discectomy in our ward. Of these, 36 out of patients had multiple surgeries, 36 individuals underwent two and 3 patients three operations. With regard to the patientsʹ previous graphs and surgery records and new graphs we determined the causes of these patientsʹ multiple surgeries. Results: Of these patients 52.7% were men and 47.3% were women. The mean interval between two operations was 28.8 months and between the second and thrid operations was 11.6 months. The most common lesions needed for resurgery were as herniated disc in adjacent space (282%), reherniation in the same space (23.7%) and spinal instability, arachnoiditis. epidural infection and hematoma with decreasing incidence. Conclusion: Doing procedure through suitable method and attention to some points of surgery may improve the results of standard discectomy and decrease the need for resurgery.