A s the incidence of spinal surgery has increased, the rate of revision surgery has also increased. Although the rate varies according to study, the revision surgery has been reported to range between 2 and 19% after discectomy, 36 9 and 17% after decompression, 7 and 6 and 36% after spinal fusion. 3 Almost 13% of patients who undergo lumbar spinal surgery also undergo a second lumbar surgery. 33 In every patient who undergoes revision surgery, a precise evaluation of underlying problems is mandatory. Revision surgeries tend to have less favorable
Sang-Ho Lee, Byung-Uk Kang, Sang Hyeop Jeon, Jong Dae Park, Dae Hyeon Maeng, Young-Geun Choi and Won-Chul Choi
Catherine A. Mazzola and Arno H. Fried
Chiari malformations comprise four different hindbrain anomalies originally described by Hans Chiari, a professor of pathology at the German University in Prague. There are four basic Chiari malformations. The reasons for revision of Chiari malformation decompression may be for conservative or inadequate initial decompression or the development of postoperative complications. Another reason involves cases of both hindbrain herniation and syringomyelia in patients who have undergone adequate posterior fossa decompression without resolution of symptoms, signs, or radiological appearance of their syrinx cavity. Additionally, symptom recurrence has been reported in association with various types of dural grafts. Reoperation or revision surgery for patients with Chiari malformations is common and may not be due to technical error or inadequate decompression. The types of revision surgeries, their indications, and initial presentations will be reviewed.
Pepijn O. Sun, Ruud W. Selles, Miguel C. Jansen, Harm P. Slijper, Dietmar J. O. Ulrich and Erik T. Walbeehm
% and 31%. 1 , 4 , 16 , 19 , 21 Five percent to 10% of patients with recurrent and persistent symptoms require revision surgery. 19 , 21 , 23 The outcome of revision surgery for recurrent and persistent CTS is less successful than that of primary surgery; the systematic review and meta-analysis of Soltani et al. 21 reported no improvement of symptoms after repeat decompression with neurolysis in up to 47% and after flap surgery in up to 37%. Furthermore, patients who do have improvement often have residual symptoms after revision surgery. 2 , 3 , 23 In order to
Imad Saeed Khan, Ashish Sonig, Jai Deep Thakur, Papireddy Bollam and Anil Nanda
left irreversible neurological side effects in the patients. Revision surgeries were defined as operations for patients who had undergone a previous same-level decompression procedure, such as a discectomy, hemilaminectomy, laminectomy, or facetectomy. Wound-related complications encompassed wound dehiscence, infection, hematoma or seroma, and suture reaction. All inadvertent DTs recognized intraoperatively were repaired with 4-0 silk suture using a running locking stitch. A subfascial drain was placed in all patients with a repaired DT and they were put on bed
Fred H. Geisler, Richard D. Guyer, Scott L. Blumenthal, Paul C. McAfee, Andrew Cappuccino, Fabien Bitan and John J. Regan
C areful patient selection is one of the most cited conditions for successful spinal surgery. This condition is particularly critical considering that 10–30% of spinal surgeries fail or generate unsatisfactory outcomes. 6 , 8 In addition, revision surgery in patients with failed–back surgery syndrome has generated mixed outcomes with successes 10 as well as disappointments. 3 Several approaches have been investigated to reduce unsatisfactory outcomes after revision surgery. Hsu and associates 7 reviewed imaging methodologies to allow more accurate
Wanru Duan, Dean Chou, Bowen Jiang, Zhenlei Liu, Xinghua Zhao, Zhiyuan Xia, Fengzeng Jian and Zan Chen
revision surgery risky, with some reported complication rates of up to 50%. 10 Few published reports have focused on revision surgery for AAD. 6 , 8 , 10 , 11 , 14 Commonly reported approaches for revision surgery include the anterior transoral approach or combined anterior and posterior approaches. In these reports, 68.8% to 90% of patients achieved complete reduction after revision surgery, and complications such as deep infection, screw loosening, or pulmonary infections had been reported. 10 , 14 However, an issue with the anterior approach is that transoral
Julia Onken, Bernhard Meyer and Peter Vajkoczy
Cervical artificial disc replacement (C-ADR) is a widely used procedure with low risk at implantation. Few cases have been reported about the surgical techniques of C-ADR revision. The authors describe their surgical experience with the explantation of a Galileo C-ADR.
Revision surgery was performed in a 58-year-old patient. Patient positioning and surgical opening techniques were performed as appropriate for anterior cervical decompression.
Revision surgery via the initial anterior approach was successful following an atraumatic removal of the implant. Fusion of the C5–6 segment was performed without complications.
In general, the authors observed recurrent nerve palsy and malpositioning of the revised implant in C-ADR revision surgery. Problems with implant removal did not occur because the fusion rate was low due to the short time between initial surgery and C-ADR revision surgery.
The video can be found here: https://youtu.be/32CUEDquinc.
Ganesh M. Shankar, Michelle J. Clarke, Tamir Ailon, Laurence D. Rhines, Shreyaskumar R. Patel, Arjun Sahgal, Ilya Laufer, Dean Chou, Mark H. Bilsky, Daniel M. Sciubba, Michael G. Fehlings, Charles G. Fisher, Ziya L. Gokaslan and John H. Shin
log-rank test was used to determine the impact of systemic chemotherapy, radiation therapy, and revision surgery on patient survival. Quality of Evidence The quality of evidence of the literature derived from our review was scored as high, moderate, low, or very low according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach 17 ( Supplementary Fig. 1 ) by consensus of the authors. The relevant studies and associated levels of evidence by GRADE criteria are summarized in Table 1 . A multidisciplinary panel of 21 members
Seiichi Odate, Jitsuhiko Shikata, Tsunemitsu Soeda, Satoru Yamamura and Shinji Kawaguchi
patients. 11 , 16 , 17 , 21 , 24 There are 2 main explanations for late deterioration after cervical laminoplasty. First, postoperative kyphotic changes in cervical alignment are not uncommon after cervical laminoplasty, but they are after ACDF. 2 , 12 Second, OPLL tends to progress more often after cervical laminoplasty than after ACDF. 3 , 8 , 10 , 21 Therefore, after cervical laminoplasty, some patients require revision surgery due to late neurological deterioration. 29 Worsening myelopathy after posterior surgery is a challenging condition to treat because it
Bungo Otsuki, Mitsuru Takemoto, Shunsuke Fujibayashi, Hiroaki Kimura, Kazutaka Masamoto and Shuichi Matsuda
W ith the development of rapid prototyping technology, several papers have described the utility of a screw insertion guide during primary spine surgery. 3 , 6 , 7 , 13 However, no report has described the use of such a guide during revision surgery. The reported guides used in primary surgery have a large contact area designed by making a conventional subtraction cast model of the shape of the lamina and/or the spinous process from the initial bulk structure ( Fig. 1 ). However, in revision surgery, many artifacts caused by previous internal implants