Laminectomy performed in primary surgery could be detected as the only factor leading to a higher rate of revisions. A trend toward poor results after recurrent disc surgery seems to be fateful because of the development of epidural fibrosis and instability. In severe discotomy syndrome, a spinal fusion seems to be more successful than multiple fibrinolyses.

No abstract

The cage geometry has a significant impact on the alignment of the lumbar spine after instrumented posterior lumbar interbody fusion. With rectangular cages, lumbar lordosis and segmental lordosis of the segments fused decrease; sagittal balance is maintained by compensatory changes of the sacral tilt. Wedge-shaped cages significantly increase segmental lordosis, enhance lumbar lordosis, and therefore should be preferred for restoring sagittal alignment in instrumented posterior lumbar interbody fusion procedures.

No abstract