Cause for failure and reoperation of lower lumbar surgery

Objective: To analyze the common cause for lower lumbar surgery and to explore the effective reoperation.Methods: Clinical data of 15 cases with failed lower lumbar surgery were analyzed retrospectively.Result: Two cases failed due to wrong operative mode,2 due to deficient decompression,2 due to infection of spine,5 due to spine instability,2 due to artificial herniated nucleus pulposus,and 1 due to loosening nail in pedicle of vertebral arch.One case had original symptoms worsened and was complicated with cauda quina injury due to failed surgery.After reoperation,the modified Macnab scale showed 4 excellent cases,9 good cases,1 fair case,and 1 poor case,with the excellent and good rate as 86.7%.Conclusions: Proper operative mode,complete decompression and fusion by internal fixer if necessary are effective to lower the operative failure rate for lower lumbar surgery.Fusion by internal fixer should be used in reoperation.