Retrospective Analysis of Re-Operation for the Lumbar Spinal Canal Stenosis

Abstract

OBJECTIVE; The results in patients with lumbar spinal canal stenosis (LCS) who undergo re-operation for failed back surgery syndrome are usually unsatisfactory. We will report our results in a series of 54 patients with recurrent LCS who were re-operated. PATIENTS AND METHOD; We reviewed 54 patients who underwent posterior re-decompression without fusion to treat recurrent LCS. All were operated at our institution during the last 5 years. At the initial operation, all patients underwent posterior decompression and 8 of them were also subjected to posterior fusion. RESULT; The most common reason for the re-operation was stenosis of the lateral recess. Further treatment after the initial operation was required in 3 patients with iatrogenic spondylolisthesis. The symptom recovery rate, assessed on the JOA score, was 68.6%. The surgical outcome was better in patients whose symptoms were present for less than 1 year before re-operation. Instability of the lumbar spine before the 2nd operation was not significantly correlated with poor outcomes. CONCLUSION; Re-operation consisting of posterior re-decompression without fusion did not worsen the clinical condition of our 54 patients. There was no significant correlation between instability of the lumbar spine before re-operation and poor outcomes. Our findings stress the importance of carefully considering the indication for fusion in patients undergoing re-operation for LCS. As we found a significant correlation between poor results and the duration of symptoms in re-operated patients, the observation period after the first operation must be limited to avoid poor outcomes.