Characteristics of clinical presentations of Failed Back surgery syndrome
https://doi.org/10.18705/2311-4495-2015-0-2-3-69-75
Abstract
Object: the aim ofthis study is to analyse a clinical presentations of Failed Back Surgery Syndrome (FBSS). The main reasons of FBSS and clinical findings corresponding to it have been studied. Materials and methods: outcomes of 40 patients with back pain, who were underwent earlier the surgery, and pain recurrence following the operation from 3 months to 4 years were analyzed by us retrospectively. Results: the main clinical presentation of FBSS were: a facet-joint syndrome in 70 %, reflex myotonic and myofascial syndromes in 61,6 %, instability in the same level or the adjacent segment in 33,3 %. Resurgery was performed apropos lumbar disc herniation recurrence, adjacent segment disease, epidural post-operative fibrosis, instability in the same level and/or the adjacent segment etc. Conclusion: revelation of the morphological reason of the pain syndrome and orthopedic and neurologic disturbances is a ground of correct treatment tactics. It may be conservative treatment of postoperative pain syndrome after microdiscectomy or a second surgery.
About the Authors
Oleg Nikolaevich Tulkin
Divisions of Polenov Russian Scienific Research Institute of Neurosurgery
Russian Federation
Russian Federation
A. S. Nazarov
Divisions of Polenov Russian Scienific Research Institute of Neurosurgery
Russian Federation
Russian Federation
E. A. Davydov
Divisions of Polenov Russian Scienific Research Institute of Neurosurgery
Russian Federation
Russian Federation
V. P. Bersnev
Divisions of Polenov Russian Scienific Research Institute of Neurosurgery
Russian Federation
Russian Federation
References
1. Борзунов, А.Н, Древаль О. Н. Причины рецидивов грыж межпозвонковых дисков на поясничном уровне. Материалы IV съезда нейрохирургов России. М., 2006. С. 15. [Borzunov A.N, Dreval’ O.N. Prichiny recidivov gryzh mezhpozvonkovyh diskov na pojasnichnom urovne. Materialy IV s#ezda nejrohirurgov Rossii. M., 2006. S. 15. In Russian].
2. Коновалов, Н. А. Алгоритмы диагностики и хирургического лечения дегенеративных заболеваний позвоночника. Материалы IX съезда травматологов и ортопедов России. Саратов, 2010. [Konovalov N.A. Algoritmy diagnostiki i hirurgicheskogo lechenija degenerativnyh zabolevanij pozvonochnika. Materialy IX s#ezda travmatologov i ortopedov Rossii. Saratov, 2010. In Russian].
3. Симонович, А. E., Байкалов А. А. Хирургическое лечение рецидивов болевых синдромов после удаления грыж поясничных межпозвонковых дисков. Хирургия позвоночника. 2005. № 3. С. 87-92. [Simonovich, A. E., Bajkalov A.A. Hirurgicheskoe lechenie recidivov bolevyh sindromov posle udalenija gryzh pojasnichnyh mezhpozvonkovyh diskov. Hirurgija pozvonochnika. 2005. № 3. S. 87-92. In Russian].
4. Скоромец, А. А., Скоромец Т. А., Шумилина А. П. Остеохондроз дисков: новые взгляды на патогенез неврологических синдромов. Неврологический журн. 1997. № 6. С. 53-55. [Skoromec, A.A., Skoromec T. A., Shumilina A. P. Osteohondroz diskov: novye vzgljady na patogenez nevrologicheskih sindromov. Nevrologicheskij zhurn. 1997. № 6. S. 53-55. In Russian].
5. Шуваева, О. Б. Клинический полиморфизм рецидивирующих болевых синдромов после оперативного вмешательства при компрессионной радикулопатии на пояснично-крестцовом уровне. Журн. невролог. и психиатр. 2005. № 11. С. 11-15. [Shuvaeva, O. B. Klinicheskij polimorfizm recidivirujushhih bolevyh sindromov posle operativnogo vmeshatel'stva pri kompressionnoj radikulopatii na pojasnichno-krestcovom urovne. Zhurn. nevrolog. i psihiatr. 2005. № 11. S. 11-15. In Russian].
6. Aydin, Y., Ziyal I. M., Duman H. Clinical and radiological results of lumbar microdiscectomy technique with preserving of ligamentum flavum comparing to the standard microdiscectomy technique. Surg. Neurol. 2002. Vol. 57. P. 5-14.
7. Cooper R. G., Mitchell W. S., Illingworth K. J. The role of epidural fibrosis and defective fibrinolysis in the persistence of postlaminectomy back pain al.. Spine. 1991. Vol. 16. P. 1044-1048.
8. Dunlop R. B., Adams M. A., Hutten W. C. Disc space narrowing and the lumbar facet joints. J. Bone Joint Surg. 1984. Vol. 66. P. 706710.
9. Findlay G. F., Hall B. I., Musa B. S. A 10-years follow-up of the outcome of lumbar microdiscectomy. Spine. 1998. Vol. 23. P. 1168-1171.
10. Porshet F., Bartanusz V., Kleinstueck F. S. Microdiscectom y compared with standard discectomy: an old problem revisited with new outcome measures within the framework of a spine surgical registry. Eur Spine J. 2009. Suppl. 3. P. 360-366.
11. Ross J. S. MR imaging of the postoperative lumbar spine. MRI Clin. N. Am. 1999. Vol. 7. P. 513-524.
12. Rodrigues F. F., Dozza D. C., de Oliveira C. R., de Castro R. G. Failed back surgery syndrome: casuistic and etiology. Arq. Neuropsiquiat. 2006. Vol.64. P. 757-761.
13. Schaller B. Failed back surgery syndrome: the role of symptomatic segmental single-level instability after lumber microdiscectomy. Eur Spine J. 2004. Vol.13. P. 193-198.
Review
For citations:
Tulkin O.N., Nazarov A.S., Davydov E.A., Bersnev V.P. Characteristics of clinical presentations of Failed Back surgery syndrome. Translational Medicine. 2015;(2-3):69-75. (In Russ.) https://doi.org/10.18705/2311-4495-2015-0-2-3-69-75
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