Etiology of Long-term Failures of Lumbar Spine Surgery

Waguespack, Alexis M; Schofferman, Jerome; Slosar, Paul; Reynolds, James B.

doi:10.1046/j.1526-4637.2002.02007.x

Cited by 147 publications

(112 citation statements)

References 9 publications

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“…In our series it did not overwhelm the results of these studies [12,53]. Moreover, the complication rates reported by Waguespack and Ebeling were higher and could be explained by different referral patterns and categories provided.…”

Section: Discussionsupporting

confidence: 55%

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: Discussionsupporting

confidence: 55%

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

2010

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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%

“…Lumbar pain can occur on disc disease, instability, pseudarthrosis. Pain initially in the inferior member can occur in canal stenosis, recurrent or residual disc herniation or for neuropathic pain 3 . To establish a correct diagnosis it is necessary to understand which structure is causing pain and then to apply the appropriate treatment.…”

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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“…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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Etiology of Long-term Failures of Lumbar Spine Surgery

Cited by 147 publications

References 9 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

Failed back surgery syndrome: casuistic and etiology

Sacroiliac joint pain after lumbar/lumbosacral fusion: current knowledge

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