Failed Back Surgery Syndrome: A Review Article

Daniell, James R.; Osti, Orso L.

doi:10.4184/asj.2018.12.2.372

Cited by 111 publications

(104 citation statements)

References 43 publications

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“…Epidural block is a good choice for interventional therapy in pain clinics [3], but caudal epidural block was not effective in this case, probably because fibrotic adhesions formed by previous surgeries may have created separations within the epidural space [13], which interfered with the spread of the analgesic solution. As a more invasive treatment that can be used when conservative treatment is ineffective in cases of FBSS, SCS can play an important role in pain management [14]. A limitation of SCS is that some patients have reported complications, such as lead migration, local wound infection, pocket pain, loss of therapeutic effects, and cerebrospinal fluid leak with headache; these do not occur with ESP block [4].…”

Section: Discussionmentioning

confidence: 99%

Erector spinae plane block for low back pain in failed back surgery syndrome: a case report

Takahashi

Suzuki

2018

JA Clin Rep

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Background: Patients with failed back surgery syndrome (FBSS) experience chronic back pain following spinal surgery, and effective treatment is difficult because of multiple contributing factors. Case presentation: Here we report a case involving a 72-year-old woman who experienced recurrent low back pain after undergoing two back surgeries. She was treated with erector spinae plane (ESP) block, which affected the dorsal rami of the spinal nerves from T12 to L5. Pain relief lasted for approximately 10 h after the initial block, and successful low back pain relief was achieved after a total of three trials. Conclusions: ESP block, which is an easy and safe procedure, can be used to treat FBSS-associated low back pain.

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Section: Discussionmentioning

confidence: 99%

Erector spinae plane block for low back pain in failed back surgery syndrome: a case report

Takahashi

Suzuki

2018

JA Clin Rep

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“…30 There are no known fully successful therapeutic modalities. 31 There may be a role for administration of perioperative intravenous lignocaine in preventing or decreasing the frequency of the failed back surgery syndrome. 32 Central sensitisation is a predictor of a poor life quality and increased length of stay following multilevel spinal surgery.…”

Section: How the Intervention Might Workmentioning

confidence: 99%

Perioperative intravenous lignocaine infusion for postoperative pain control in patients undergoing surgery of the spine: protocol for a systematic review and meta-analysis

Licina

Silvers

2020

BMJ Open

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IntroductionIntravenous lignocaine is an amide local anaesthetic known for its analgesic, antihyperalgesic and anti-inflammatory properties. Administration of intravenous lignocaine has been shown to enhance perioperative recovery parameters. This is the protocol for a systematic review which intends to summarise the evidence base for perioperative intravenous lignocaine administration in patients undergoing spinal surgery.Methods and analysisOur primary outcomes include: postoperative pain scores at rest and movement at predefined early, intermediate and late time points and adverse events. Other outcomes of interest include perioperative opioid consumption, composite morbidity, surgical complications and hospital length of stay. We will include randomised controlled trials, which compared intravenous lignocaine infusion vs standard treatment for perioperative analgesia. We will search electronic databases from inception to present; MEDLINE, EMBASE and Cochrane Library (Cochrane Database of Systematic Reviews and CENTRAL). Two team members will independently screen all citations, full-text articles and abstract data. The individual study risk of bias will be appraised using the Cochrane risk of bias tool. We will obtain a risk ratio or mean difference (MD) from the intervention and control group event rates based on the nature of data. We will correct for the variable measurement tools by using the standardised MD (SMD). We will use a random-effects model to synthesise data. We will conduct five subgroup analysis: major versus minor surgery, emergency versus elective surgery, patients with chronic pain conditions versus patients without, duration of lignocaine infusion and adult versus paediatric. Confidence in cumulative evidence for will be classified according to the Grading of Recommendations, Assessment, Development and Evaluation system. We will construct summary of findings tables supported detailed evidence profile tables for predefined outcomes.Ethics and disseminationFormal ethical approval is not required as primary data will not be collected. The results will be disseminated through a peer-reviewed publication.PROSPERO registration numberCRD420201963314

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“…These processes are inevitable following laminectomy; however, they can lead to serious complications that are nominally referred to as failed back surgery syndrome. 1,2 Adhesions and fibrous scars extrude to the spinal dural causing nerve root compression, which results in radicular pain and functional impairment in the lower limbs. The pathophysiology mechanism of postoperative epidural fibrosis is not well understood, but the accepted view is that hematoma formation, the accumulation of inflammatory cytokines, fibroblast proliferation and collagen synthesis accelerate fibrous adhesion formation in the epidural operational area after surgical trauma.…”

Section: Introductionmentioning

confidence: 99%

Icariin-loaded electrospun PCL/gelatin sub-microfiber mat for preventing epidural adhesions after laminectomy

Huang¹,

Shi²,

Gong³

et al. 2018

IJN

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BackgroundEpidural adhesion is one of the major reasons attributed to failed back surgery syndrome after a successful laminectomy, and results in serious clinical complications which require management from physicians. Therefore, there is an urgent demand within the field to develop biodegradable anti-adhesion membranes for the prevention of post-operative adhesion.MethodsIn this study, icariin (ICA) was initially loaded into polycaprolactone (PCL)/gelatin fibers via electrospinning to fabricate nanofibrous membranes. The effects of the ICA content (0.5wt%, 2wt% and 5wt%) and the bioactivity of ICA in the nanofibrous membranes were investigated in vitro and in vivo.ResultsThe nanofibrous membranes showed suitable pore size and good properties that were unaffected by ICA concentration. Moreover, the ICA-loaded membranes exhibited an originally rapid and subsequently gradual sustained ICA release profile that could significantly prevent fibroblast adhesion and proliferation. In vivo studies with rabbit laminectomy models demonstrated that the ICA-loaded membranes effectively reduced epidural adhesion by gross observation, histology, and biochemical evaluation. The anti-adhesion mechanism of ICA was found to be via suppression of the TGF-β/Smad signaling proteins and down regulation of collage I/III and a-SMA expression for the first time.ConclusionWe believe that these ICA-loaded PCL/gelatin electrospun membranes provide a novel and promising strategy to resist adhesion formation following laminectomy in a clinical application.

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Failed Back Surgery Syndrome: A Review Article

Cited by 111 publications

References 43 publications

Erector spinae plane block for low back pain in failed back surgery syndrome: a case report

Erector spinae plane block for low back pain in failed back surgery syndrome: a case report

Perioperative intravenous lignocaine infusion for postoperative pain control in patients undergoing surgery of the spine: protocol for a systematic review and meta-analysis

Icariin-loaded electrospun PCL/gelatin sub-microfiber mat for preventing epidural adhesions after laminectomy

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