Treatment of the Failed Back Surgery Syndrome Due to Lumbo-Sacral Epidural Fibrosis

Fiume, D; Sherkat, Shahram; Callovini, Gemma; Parziale, Giuseppe; Gazzeri, G

doi:10.1007/978-3-7091-9419-5_25

Cited by 85 publications

(52 citation statements)

References 20 publications

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“…The reherniation rate along with other entities: segmental instability, facet joint disease, epidural fibrosis, incomplete or wrong level decompression, and poor patient selection could be attributed to the relatively frequent manifesting FBSS, comprising from 5 to 10% of lumbosacral spine surgery cases [16,49]. In our series it did not overwhelm the results of these studies [12,53].…”

Section: Discussioncontrasting

confidence: 29%

“…Along with the clinical examinations, computed tomography (CT) and magnetic resonance imaging (MRI), the paraclinical diagnostic techniques are frequently applied due to the additional standardized screening of patients for those surgical interventions [4,16,21]. The generic measurements are broadly applicable and therefore employed across patient population, as they could be cheaply and lightly used for the additional screening.…”

Section: Introductionmentioning

confidence: 99%

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Clinical outcomes of patients with lumbar disc herniation, selected for one-level open-discectomy and microdiscectomy

2010

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The aim of our study was twofold: firstly, to compare the preoperative and postoperative results at midterm follow-up periods along with the data of the control group. Secondly, to evaluate the effectiveness among opendiscectomy and microdiscectomy surgical groups. In the present study, we investigated a cohort of 100 patients with the lumbar disc herniation causing low back pain compared to 100 subjects of the control group with the non-specific low back pain by applying physical activity, pain scale, Short Form 36 General Health Questionnaire and additional postoperative records of patient's satisfaction and complications level, consumption of analgesics, and return to work status. The quantitative analysis of all questionnaires showed substantial differences in the preoperative and postoperative groups. The best results were achieved at the second year follow-up period. However, there were no statistically significant differences in both the examined surgical subgroups (p [ 0.05). In addition, we estimated from moderate to great statistical significance (p \ 0.01-0.05) among preoperative and overall postoperative results: PHC and MHC in the SF-36, Oswestry and VAS. The total increased satisfaction, reherniation rate and return to work frequency comprised 40, 9 and 64%, respectively. The analgesics were still indicated for 21% of the patients. The results of the present study suggest of sufficient decompression in both surgical groups, as the health-related quality of life parameters (Oswestry, VAS and SF-36) were defined as clinically improved. Regardless of persisted minor pain in both areas, it remained greater in the low back than in the leg, which should be held for beneficial to decompressive surgery.

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Section: Discussioncontrasting

confidence: 29%

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of patients with lumbar disc herniation, selected for one-level open-discectomy and microdiscectomy

2010

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“…Development of dense scar tissue adjacent to the dura mater after laminectomy is a natural process of healing (1,2). Histological studies have revealed that epidural fat destruction, epidural hematoma, and muscle fiber invasion from spine erector muscles into the laminectomy site are the main factors responsible for dense epidural scar adhesion formation.…”

Section: Introductionmentioning

confidence: 99%

Effects of cepae extract, allantoin, and heparin mixture on developing andalready formed epidural fibrosis in a rat laminectomy model

et al. 2016

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“…The most frequent causes of FBS 7,13 are bad selection of patients, disregard of personality and psychosocial factors, surgery at the wrong level, inadequate surgical techniques, recurrent disk herniation, and epidural ®brosis.…”

Section: Operative Treatmentmentioning

confidence: 99%

Aspects of the failed back syndrome: role of litigation

Pearce

2000

Spinal Cord

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Objective: A review that attempts to identify the mechanism and causation of persistent or recurring low back pain. Design: A personal assessment of clinical features with a selective review of the literature. Results: Thirty to forty per cent of our population aged 10 ± 65 years report that back trouble occurs on a monthly basis and in 1% to 8% this interferes with work. A de®nite patho-anatomical cause for the pain is demonstrable in only a minority. It can be deduced that psychosocial factors, including insurance bene®ts are of importance for this variation. Conclusions: Neither non-operative nor surgical procedures have a major impact on the capacity for work in this substantial minority of backache su erers. The main risk factors identi®ed are: Wrong diagnosis, repeated medical certi®cates for sickness bene®ts, failed surgery, symptoms incongruous with signs or imaging, multiple spinal procedures, poor social support and poor motivation, psychological illness, clinical depression before or after injury or operation. Pending compensation and delays in settlement are important additional features in claimants for compensation. For patients with unproven diagnostic labels such as`painbehaviour', no evidence exists that any type of surgery is cost e ective.

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Treatment of the Failed Back Surgery Syndrome Due to Lumbo-Sacral Epidural Fibrosis

Cited by 85 publications

References 20 publications

Clinical outcomes of patients with lumbar disc herniation, selected for one-level open-discectomy and microdiscectomy

Clinical outcomes of patients with lumbar disc herniation, selected for one-level open-discectomy and microdiscectomy

Effects of cepae extract, allantoin, and heparin mixture on developing andalready formed epidural fibrosis in a rat laminectomy model

Aspects of the failed back syndrome: role of litigation

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