Adjacent segment syndrome after failed back surgery: biomechanics, diagnosis, and treatment

Rubio-Haro, Ruben; Andres-Serrano, Carmen De; González, David César Noriega; Bordes-García, Clara; Andrés, José De

doi:10.23736/s0375-9393.21.15939-5

Cited by 8 publications

(8 citation statements)

References 69 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Others have also reported on greater (worse) functional outcomes scores after surgery [12][13][14] . Although our retrospective analysis was not designed to identify specific causes of failed back surgery for which there is a myriad of reasons, including inadequate nerve root decompression, inadequate stabilization, failure to fuse, instrumentation failure, and epidural fibrosis [15,16] , careful screening of patients before surgery will help reduce peri-and post-operative risks and contribute to better functional outcomes [17] . When comparing PLF to IBF, others report mixed results, ranging from the equivalence between the two to favoring IBF.…”

Section: Discussionmentioning

confidence: 99%

Methods of fusion did not have any significant role in improving the functional outcome in the management of grade 1,2 degenerative spondylolisthesis at 5-year follow-up

AN¹,

R²,

Muthu³

2022

Int. J. Orthop. Sci.

View full text Add to dashboard Cite

Background:We conducted this study to compare the functional outcome of patients who underwent posterolateral fusion for the management of grade 1,2 degenerative spondylolisthesis with patients who underwent interbody fusion for the same condition. Studies on either of the treatment methods demonstrated significant improvement but the latter is implant driven while the former is not. Although radiological outcomes were found to be better in the interbody fusion we aimed to compare and analyze the functional outcome in these two groups of patients. Methods: This is a retrospective cohort study analyzing 44 patients undergoing posterolateral fusion and 46 patients undergoing interbody fusion for grade 1,2 degenerative spondylolisthesis with a minimum 5year follow-up were reviewed. Patient demographics, the functional outcome with Oswestry Disability Index (ODI), and complications were analyzed. Results: Although we noted significant improvement in the ODI scores (p<0.001) compared to the preoperative status, we did not find any significant difference in the ODI scores at 5-year follow-up between the cohorts (p=0.96). We did not find any significant difference in the complication rate (p=0.54) or reoperation rates (p=0.93) between the two groups. Conclusion:The method of fusion did not have a significant role in improving the functional outcome in the management of grade1,2 degenerative spondylolisthesis. There was also no significant difference between the two methods of fusion concerning the dural tear rates, reoperation rate, or infection.

show abstract

Section: Discussionmentioning

confidence: 99%

Methods of fusion did not have any significant role in improving the functional outcome in the management of grade 1,2 degenerative spondylolisthesis at 5-year follow-up

AN¹,

R²,

Muthu³

2022

Int. J. Orthop. Sci.

View full text Add to dashboard Cite

show abstract

“…The recurrence of foraminal stenosis or intervertebral disc herniation may be due to the worsening of an existing disease, incomplete surgery, or changes in the structures around the surgery [ 20 ]. Spinal fusion surgery can place additional stress on the adjacent vertebrae, leading to accelerated degeneration and pain in those segments [ 21 ]. In some cases, spondylolisthesis or spinal stenosis progresses rapidly due to increased dynamics in the adjacent segments above and below the surgical site.…”

Section: Etiologymentioning

confidence: 99%

Multimodal management strategies for chronic pain after spinal surgery: a comprehensive review

Yoon,

Son,

Lee

et al. 2024

Anesth Pain Med

View full text Add to dashboard Cite

“Chronic pain after spinal surgery” (CPSS) is a nonspecific term for cases in which the end result of surgery generally does not meet the preoperative expectations of the patient and surgeon. This term has replaced the previous term i.e., failed back surgery syndrome. CPSS is challenging for both patients and doctors. Despite advancements in surgical techniques and technologies, a subset of patients continue to experience persistent or recurrent pain postoperatively. This review provides an overview of the multimodal management for CPSS, ranging from conservative management to revision surgery. Drawing on recent research and clinical experience, we aimed to offer insights into the diverse strategies available to improve the quality of life of CPSS patients.

show abstract

“…[2,3] However, CSEA may be challenging when faced with patients in obesity, advanced age, adjacent segment degeneration, or reduced spinal mobility. [4][5][6] In patients with predictable difficulty of spinal anatomy, especially obese, the failure rate of spinal anesthesia or CSEA is as high as 17%. [7][8][9] Traditional landmark-guided method is often faced with inaccurate positioning.…”

Section: Introductionmentioning

confidence: 99%

Administration of combined spinal epidural anesthesia with ultrasound-assisted positioning in obese patients undergoing open hysterectomy: A randomized controlled trial

Yang,

Zhang,

Zhong

et al. 2023

Medicine

View full text Add to dashboard Cite

Background: Administration of combined spinal epidural anesthesia (CSEA) with traditional landmark-guided positioning can be challenging in patients with high body mass index (BMI). The popularization of ultrasound technology may effectively solve these problems. However, reports on the administration of CSEA ultrasound-assisted positioning in obese populations are relatively limited and have made inconsistent conclusions. We aimed to investigate the ability of ultrasound-assisted positioning to improve the success rate of CSEA in obese patients. Methods: Overall, 118 adult women with a BMI ≥ 30 kg/m2 who scheduled to undergo open hysterectomy and received CSEA were recruited. Finally, 108 patients were enrolled and randomly assigned to 2 groups: the ultrasound-assisted positioning group (group A) and traditional landmark-guided positioning group (group B). Ultrasound-assisted or landmark-guided positioning was employed to locate the puncture interspace before anesthesia. The primary outcomes were the success rate of first attempt and number of attempts. The secondary outcomes were the patient positioning accuracy, positioning time, CSEA operation time, patient-satisfaction scores, anesthesia characteristics, and complications of CSEA. Results: The success rate of patient first puncture attempt in group A was significantly higher than that in group B (78.4% vs 52.9%, P = .007). The total number of punctures was lower in group A than that in groups B (average rank 44.54 vs 58.46, P = .005). Using ultrasound positioning as the gold standard, the accuracy of landmark-guided location was only 67%. Positioning time in croup A was longer in group A than that in group B (P = .004), while CSEA operation time spent in Group A was less than that in Group B (P < .001). Patient satisfaction score in group A was significantly higher than that in group B (P = .002). The successful puncture interspace in group A were more likely at L3-4 than that in group B (P = .02). Conclusion: The success rate of first puncture attempt and positioning accuracy in CSEA with ultrasound-assisted is significantly higher than those based on landmark-guided location in obese patients.

show abstract

Adjacent segment syndrome after failed back surgery: biomechanics, diagnosis, and treatment

Cited by 8 publications

References 69 publications

Methods of fusion did not have any significant role in improving the functional outcome in the management of grade 1,2 degenerative spondylolisthesis at 5-year follow-up

Methods of fusion did not have any significant role in improving the functional outcome in the management of grade 1,2 degenerative spondylolisthesis at 5-year follow-up

Multimodal management strategies for chronic pain after spinal surgery: a comprehensive review

Administration of combined spinal epidural anesthesia with ultrasound-assisted positioning in obese patients undergoing open hysterectomy: A randomized controlled trial

Contact Info

Product

Resources

About