[Reoperations in lumbar discopathies].

In the years 1976-1990 at the Neurosurgery Centre in Rzeszów 938 patients were treated surgically for lumbar discopathy. Reoperation was necessary in 5.4% of cases. In 0.6% of them purulent wound infection was the cause, in the remaining 4.8% lacking improvement or recurrence of sciatic pain after 1 month to 12 years. In 2.2% of cases the cause of pain recurrence was recurrent hernia at the same or other level, and after its removal sciatic pain disappeared. Root compression by cicatricial tissue or osteophyte caused reoperation in 1% and surgical decompression of the root gave only minor improvement. Lacking improvement after the first operation was due in 0.7% of cases to a fragment of the nucleus pulposus left in the vertebral canal and in 0.6% the cause was failure to recognize two-level discopathy. After reoperation in such cases all pains regressed. The analysis showed that the frequency of repeated interventions would be diminished by careful excochleation of the intervertebral space, operative revision of the space with comparison with the results of radiculography and clinical examination, and not too late decision of operation.