Brugger G, Witzmann A
Wien Med Wochenschr. 1984 Sep 30;134(18):399-402.
This retrospective study concerns 48 patients who underwent reoperation some time after lumbar disc surgery because of persistent or recurring leg pain. During the same period (January 1980 to October 1982) 821 primary lumbar discectomies were done. Surgical findings at reoperation of 48 patients: 30 patients (3%) had a recurrent disc herniation at the previous site, 9 patients (1%) had disc herniations at a new site only, and 9 patients (1%) had only considerable epidural scar formation. The preoperative differentiation between symptoms related to recurrent disc herniation and those related to epidural scar formation is difficult, because in this situation myelography can not be relied upon. In our series of 48 patients, myelography showed in 27% of the cases false positive or false negative results. The clinical signs and symptoms are therefore of paramount importance.
这项回顾性研究涉及48例因持续性或复发性腿痛在腰椎间盘手术后一段时间接受再次手术的患者。在同一时期（1980年1月至1982年10月），共进行了821例初次腰椎间盘切除术。48例患者再次手术的外科发现：30例患者（3%）在先前部位出现复发性椎间盘突出，9例患者（1%）仅在新部位出现椎间盘突出，9例患者（1%）仅出现大量硬膜外瘢痕形成。术前区分与复发性椎间盘突出相关的症状和与硬膜外瘢痕形成相关的症状很困难，因为在这种情况下不能依赖脊髓造影。在我们的48例患者系列中，脊髓造影在27%的病例中显示出假阳性或假阴性结果。因此，临床体征和症状至关重要。
