Etiologies of Failed Back Surgery Syndrome

Slipman, Curtis W.; Shin, Carl H.; Patel, Rajeev K.; Isaac, Zacharia; Huston, Chris W.; Lipetz, Jason S.; Lenrow, David A.; Braverman, Debra L.; Vresilovic, Edward J.

doi:10.1046/j.1526-4637.2002.02033.x

Cited by 194 publications

(141 citation statements)

References 54 publications

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“…To include the patient correctly in a definitive pathology, it is important to know the concepts of each disease and they are very well described in the article of Slipman 1 .…”

Section: Discussionmentioning

confidence: 99%

“…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%

“…There is a great discussion around of the division in surgical and nonsurgical causes ( Table 1), being that some authors question this method. There is difficult in establishing definitions of nonsurgical causes because exist variable criteria in the medical concepts, what occurs probably for differences in specialty medical, practice setting, cultural and patient population 1 . Already in the surgical area, bigger precision in the terms occurs, since has possibility of the use of complementary examinations that allow greater accuracy of the diagnosis.…”

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%

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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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“…To include the patient correctly in a definitive pathology, it is important to know the concepts of each disease and they are very well described in the article of Slipman 1 .…”

Section: Discussionmentioning

confidence: 99%

Section: Resumo -Objetivomentioning

confidence: 99%

Section: Resumo -Objetivomentioning

confidence: 99%

Section: Resumo -Objetivomentioning

confidence: 99%

See 2 more Smart Citations

Failed back surgery syndrome: casuistic and etiology

Rodrigues

Dozza

Oliveira

et al. 2006

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

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“…Indeed, some patients continue to complain of persistent or new low back pain after surgery. Cases of recurrent low back pain and/or lower extremity pain after lumbar/lumbosacral surgery are referred to as failed back surgery syndrome [5][6][7][8][9][10][11]. Several authors have suggested that the sacroiliac joint (SIJ) may be a possible source of persistent pain [4,12,13].…”

Section: Introductionmentioning

confidence: 99%

Sacroiliac joint pain after lumbar/lumbosacral fusion: current knowledge

Yoshihara

2012

Eur Spine J

109

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Recently, the sacroiliac joint (SIJ) has gained increased attention as a source of persistent or new pain after lumbar/lumbosacral fusion. The underlying pathophysiology of SIJ pain may be increased mechanical load, iliac crest bone grafting, or a misdiagnosis of SIJ syndrome. Imaging studies show more frequent degeneration of the SIJ in patients with lumbar/lumbosacral fusion than in patients without such fusion. Using injection tests, it has been shown that SIJ pain is the cause of persistent symptoms in a considerable number of patients after fusion surgery. Recent articles reporting on surgical outcomes of SIJ fusion include a high percentage of patients who had lumbar/lumbosacral fusion or surgery before, although well-controlled clinical studies are necessary to assess the efficacy of surgical treatment. Taking these findings into consideration, the possibility that the SIJ is the source of pain should be considered in patients with failed back surgery syndrome after lumbar/lumbosacral fusion.

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Variations of the piriformis and sciatic nerve with clinical consequence: A review

2009

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The deep gluteal region is often encountered when performing injections, when performing surgery such as total hip replacements, or diagnosing problems of this region or lower limbs using clinical or imaging techniques. Previously, the prevalence figures of piriformis and sciatic nerve anomalies have ranged from 1.5 to 35.8% in dissected specimens. This study systematically reviews and meta-analyses the prevalence of piriformis and sciatic nerve anomalies in humans using previously published literature. A further review is conducted regarding the anatomical abnormalities present in surgical case series of procedures for patients suffering from piriformis syndrome. After pooling the results of 18 studies and 6,062 cadavers, the prevalence of the anomaly in cadavers was 16.9%; 95% confidence interval (CI) 16.0-17.9%. The prevalence of the piriformis and sciatic nerve anomaly in the surgical case series was 16.2%, 95% CI: 10.7-23.5%. The difference between the two groups was not found to be significant 0.74%; 95% CI: -5.66 to 7.13; P = 0.824. Because of the high likelihood of an anomaly being present in a patient, clinicians and surgeons should be aware of the potential complications this anomaly may have on medical or surgical interventions. Furthermore, because the prevalence of the anomaly in piriformis syndrome patients is not significantly different from what is thought to be a normal population, it indicates that this anomaly may not be as important in the pathogenesis of piriformis syndrome as previously thought.

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Etiologies of Failed Back Surgery Syndrome

Abstract: FBSS is a syndrome consisting of a myriad of surgical and nonsurgical etiologies. Approximately one half of FBSS patients have a surgical etiology. Approximately 95% of patients can be provided a specific diagnosis.

Cited by 194 publications

References 54 publications

Failed back surgery syndrome: casuistic and etiology

Failed back surgery syndrome: casuistic and etiology

Sacroiliac joint pain after lumbar/lumbosacral fusion: current knowledge

Variations of the piriformis and sciatic nerve with clinical consequence: A review

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