Failed back surgery: etiology and diagnostic evaluation

Schofferman, Jerome; Reynolds, James B.; Herzog, Richard J.; Covington, Edward C.; Dreyfuss, Paul; O’Neill, Conor

doi:10.1016/s1529-9430(03)00122-0

Cited by 167 publications

(109 citation statements)

References 14 publications

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“…18 Reasons for this failure are: 1) dural fibrosis, 2) arachnoidal adhesions, 3)muscle & fascial fibrosis 4) mechanical instability resulting from the partial removal of bony and ligamentous structures required for surgical exposure and decompression leading to facet & sacro-iliac joint dysfunctions, 5) radiculopathy, 6)recurrent disc herniation. [19][20][21] There has been surge of interest in search of safer alternative method of decompressing the nerve roots maintaining the structural stability. Undoubtedly, the epidural steroid injection [ESI] is the precursor of the more specific spinal injection procedures done today and the most familiar to primary care physicians.…”

Section: Ozone Disc Nucleolysis and Epidural Steroidmentioning

confidence: 99%

Interventional pain management procedure for treating low back pain: anaesthesiologists should come forward

Sardar

Sultana

Das³

et al. 2014

j Bangladesh Soc Anaesthesiologists

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Section: Ozone Disc Nucleolysis and Epidural Steroidmentioning

confidence: 99%

Interventional pain management procedure for treating low back pain: anaesthesiologists should come forward

Sardar

Sultana

Das³

et al. 2014

j Bangladesh Soc Anaesthesiologists

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“…It is not a definitive diagnosis and it is considered a syndrome because it has many explanatory etiologies as clinical as surgical [1][2][3][4][5] . The main factor is to delineate its cause through the evaluation of clinical history, physical examination and psycho-partner-economic profile, since the treatment is specific and individualized.…”

Section: Resumo -Objetivomentioning

confidence: 99%

“…In the epidemiologic studies revised, the main causes are foraminal stenosis, internal disc disruption, pseudarthrosis and neuropathic pain, which together, correspond more than 70% [1][2][3][4] . A practical method is divide the patients into those with predominance of lumbar pain versus predominance of leg pain, this allows to establish a logical sequence that will be used to carry the complementary examinations.…”

Section: Resumo -Objetivomentioning

confidence: 99%

Failed back surgery syndrome: casuistic and etiology

Rodrigues

Dozza

Oliveira

et al. 2006

Arq. Neuro-Psiquiatr.

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OBJECTIVE: To report our data of cases of failed back surgery syndrome (FBSS) and surgical and nonsurgical etiologies. METHOD: The medical charts of 121 patients submitted to laminectomy, hemilaminectomy combined with discectomy and/or foraminotomy between January 1997 and October 2004 in the Instituto of Neurologia Deolindo Couto were reviewed. The inclusion criterion was does not improve or the symptoms return after the surgery and with a minimum of three medical consultations with adequate investigation for the diagnosis. The patients had been divided in three main pre-surgical diagnosis: herniated disc, lumbar stenosis and the association of these. RESULTS: From the 121 patients submitted to spine surgical intervention, 47 (38.8%) had presented criteria for the FBSS. Among the 26 patients who had presented operative diagnosis of lumbar stenosis, 8 (30.7%) had presented FBSS; of the 83 with disc herniation, 31 (37.3%) had the syndrome; and the 12 patients with lumbar stenosis associated with disc herniation, 7 (58.3%) had failure of the back surgery. CONCLUSION: The failure of back surgery remains a challenge for the surgeons. There is an incessant search for the causes and the action mechanisms of this syndrome and the best method of treatment.

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“…3 Hence these cases require thorough analysis before surgical intervention. 4 Before surgical removal of disc all means of conservative therapy should be exhausted. Epidural 2013 to April 2015.…”

Section: Introductionmentioning

confidence: 99%

“…3 The etiology of failed back surgery can be poor patient selection, incorrect diagnosis, poor surgical technique and/or recurrent pathology. 4,12 Recurrent disc herniation is reported in 3 -7% cases. 3 Hence before operating a patient with low back pain all means of conservative treatment should be tried to prevent failed back syndrome.…”

mentioning

confidence: 99%

Ozone discolysis in lumbar disc prolapse

et al. 2017

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Background: Treatment of low back ache due to prolapsed intervertebral disc is still controversial. Several conservative modalities are available with varied results. Surgical discectomy may lead to failed back syndrome due to change in vertebral column anatomy and its mechanics. To prevent it, conservative means are better and Ozone discolysis is one of the nonsurgical methods. The indications and effectiveness of this condition is not well defined. The present study was done to correlate the clinical outcome of this technique.Methods: This was a prospective study conducted on 67 patients presenting with symptoms of back pain with arid without radicular symptoms. X ray and MRI were done in all cases. Then intradiscal ozone gas was given at one level from a specialized machine under C arm guidance. For evaluation Oswestry disability index and Macnab scoring system was used. Post injection patients were evaluated at 2, 6 weeks and 6 months.Results: Sixty seven patients with mean age of 47.7 years were followed up for 7.8 months. Low back pain was the commonest symptom and SLR was positive in 5.36%. The modified Macnab scoring with good and fair score improved from 16% to 89% and Oswestry disability index with minimal and moderate disability improved from 41% to 91% at end of 6 months. Seven patients had relapse of pain due to repeat disc prolapse. Conclusions: Ozone discloses is better modality of treatment for low back pain with disc bulge and early disc prolapsed.

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Failed back surgery: etiology and diagnostic evaluation

Cited by 167 publications

References 14 publications

Interventional pain management procedure for treating low back pain: anaesthesiologists should come forward

Interventional pain management procedure for treating low back pain: anaesthesiologists should come forward

Failed back surgery syndrome: casuistic and etiology

Ozone discolysis in lumbar disc prolapse

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