Reasons for repeated surgical interventions in patients after surgery for spinal disc herniation
Background. The article presents a retrospective analysis of the causes of negative results of surgical treatment in elderly people with spinal disc herniation. The purpose of the work is to determine the causes of negative results of surgical treatment of disc herniation in the elderly and old patients compared with young patients, which will allow choose the correct surgical tactics in the future and prevent the complications. Materials and methods. A retrospective analysis of the surgical treatment of spinal disc herniation in 170 patients was carried out. The group of young people consisted of 92 patients, the group of elderly and senile age (60 years and older) included 78 patients. The first operation for disc herniation was performed from 3 months to 7 years before investigation in various medical institutions of Ukraine. Results. The disc herniation at the same level recurred in 61 % of young patients and almost 4 times less (14.1 %) in older ones. Disc herniation at an adjacent level is also found more often in young patients (10 %) than in the older age group (3.8 %). The authors attribute this fact to the more expressive disc dehydration with age, and the height of the interbody space is significantly reduced, while in young people the volume of the disc material significantly increases the risk of new sequestration. Conclusions. The results of this work indicate that the reasons for repeated surgical interventions for disc herniation depend on the age of a patient. A common cause of repeated surgical interventions in older patients is instability at the operated and adjacent levels, encouraging surgeons to more widely use stabilizing surgical interventions and more detailed preoperative planning for choosing a level of stabilization; in the older age category, stenosis prevails, therefore it is necessary to apply a wider decompression.
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