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Outline 2. Factors predicting outcome from repeat
lumbar surgery
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Predictive of a good outcome

  Greater than 6 months' pain relief after previous
  surgery

  Leg pain worse than back pain

  Nerve root compression from disk or bone

  Contrast study correlates with clinical examination

  Neurologic deficit

  No litigation

  Noncompensable cause of pain

  Solid fusion achieved

Predictive of a poor outcome

  Less than 6 months' pain relief

  Scarring, fibrosis found at surgery

  Radiographic edvidence of arachnoiditis

  Poor psychological profile

  Litigation active

  Compensable cause of pain

  Multiple operations

  Substance abuse
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(Reproduced with permission from Barnard T: Repeat
lumbar spine surgery: Factors influencing outcome.
Spine 1993;18:2196-2200.)
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Beaty, JH (ed): Orthopaedic Knowledge Update 6. Rosemont, IL. American Academy of Orthopaedic Surgeons. 1999 Ch. 51, pp. 685-698.