Treatment and pathomechanism of recurrent lumbar disc herniation
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概要
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During 1981 to 1991, we operated on 331 patients with lumbar disc herniation. Nineteen cases out of those were reoperated due to the recurrence of symptoms. There were 17 males and 2 females with a mean of 45.7 years ranging from 16 to 67 years. The recurrence period ranged from 13 months to 10 years (mean, 3 years and 9 months).<BR>The level of operated disc was L3/4 in 2 cases, L4/5 in 13, L5/S in 6, L5/6 in 2 in the initial operation. The surgical technique with Love's method was used in 15 cases, hemilaminectomy in 2, laminectomy in 1, and anterior body fusion in 1. The herniation recurred in the same site and same level on 10 cases, in the same level and the opposite site on 6 cases. Recurrence occurred in neiboring level on 3 cases.<BR>The posterior approach was used in the reoperations with extripation of the recurrent disc herniations. Posterolateral fusion was performed in one case.<BR>The improvement ratio of JOA scoring system for lumbar herniation was a mean of 76% at follow-up, and 11 out of 19cases returned to the same job.<BR>Fat graft technique seems to be a useful method to prevent the scar formation around the dura in the operation of lumbar disc herniation.
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