This Article
Right arrow Full Text (PDF)
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowReprints and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Waddell, G.
Right arrow Articles by McCulloch, J. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Waddell, G.
Right arrow Articles by McCulloch, J. A.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Technorati  
What's this?

The Journal of Bone and Joint Surgery, Vol 61, Issue 2 201-207, Copyright © 1979 by Journal of Bone and Joint Surgery, Inc

JOURNAL CONTENTS

Failed lumbar disc surgery and repeat surgery following industrial injuries

G Waddell, EG Kummel, WN Lotto, JD Graham, H Hall and JA McCulloch

One hundred and seventy-nine of the compensation patients in this study who had one low-back operation had to have repeat back surgery. One hundred and three Workmen's Compensation Board patients who were reoperated on by a number of surgeons in the Toronto area were independently reviewed with one to two years of follow-up. Many had residual back pain, limited lumbar movement, presisting nerve-root deficits, and psychological disturbances. Forty per cent of the second operations were successful. Subsequent operations yielded progressively poorer results and made more patients worse than better. Operations were frequently undertaken without clear indications or evidence of correctable organic lesions. The results of repeat operations were better when the preceding operation had given more than six months' relief, when sciatica overshadowed back pain, and when a definite recurrent disc herniation was found. Scarring and neurolysis, previous infection, repair of a pseudarthrosis, and adverse psychological factors precluded a good result. Careful patient selection based on total evaluation of the disability including psychological assessment, accurate localization of the lesion by detailed investigation, and, most important, a logical sequence of decisions based on clear, objective criteria are prerequisites for this complex and demanding surgery. Caution and restraint are required when contemplating repeat back surgery.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 JBJSHome page
L. Y. Carreon, R. M. Puno, J. R. Dimar II, S. D. Glassman, and J. R. Johnson
Perioperative Complications of Posterior Lumbar Decompression and Arthrodesis in Older Adults
J. Bone Joint Surg. Am., November 1, 2003; 85(11): 2089 - 2092.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
G. STEWART and B. L. SACHS
Patient Outcomes after Reoperation on the Lumbar Spine
J. Bone Joint Surg. Am., May 1, 1996; 78(5): 706 - 11.
[Abstract] [Full Text]

Home page
 JBJSHome page
M. C. T. CARPENTER, M. J. W. DIETZ, K. Y. K. LEUNG, D. A. HANSCOM, and T. A. WAGNER
Repair of a Pseudarthrosis of the Lumbar Spine. A Functional Outcome Study*{{dagger}}
J. Bone Joint Surg. Am., May 1, 1996; 78(5): 712 - 20.
[Abstract] [Full Text]

Home page
 Clin RehabilHome page
C. J Main and G. Waddell
Personality assessment in the management of low back pain
Clinical Rehabilitation, May 1, 1987; 1(2): 139 - 142.
[PDF]