The post spinal surgery syndrome

Chaurasia, Bipin; Ramnarayan, R

doi:10.4103/jcvjs.jcvjs_118_22

Cited by 7 publications

(3 citation statements)

References 43 publications

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“…One of the participants advocated for the application of robotics in LMICs. In summary, the successful adoption of ED in LMICs can be achieved using a “6Ts” framework as follows:[ 40 41 42 43 44 45 46 47 48 49 50 ] Target identification, i.e. accurate diagnosis of patients’ conditions to determine the indication of ED; Technology, referring to wider access to technology to establish and update the endoscopy system; updating Techniques to parallel the evolution of novel and modified techniques; Training, both during and postresidency, using artificial models and cadavers; Testing, which means continuous outcome evaluation; and Talent comprising of innate and acquired surgical skills which can be evaluated using essential metrics, as Melcher et al .…”

Section: Discussionmentioning

confidence: 99%

Endoscopic versus microscopic discectomy for pathologies of lumbar spine: A nationwide cross-sectional study from a lower-middle-income country

Pahwa,

Tayal,

Chowdhury

et al. 2023

Journal of Craniovertebral Junction and Spine

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Objective: We conducted a cross-sectional study to assess the preference of spine surgeons between MD for microdiscectomy and endoscopic discectomy (ED) surgery for the management of lumbar pathologies in a lower-middle-income country (LMIC). Methodology: An online survey assessing the preference of spine surgeons for various lumbar pathologies was developed and disseminated in “Neurosurgery Cocktail” a social media platform. Statistical analyses were performed using SPSS software with a level of significance <0.05. Results: We received responses from 160 spine surgeons having a median experience of 6.75 years (range 0–42 years) after residency. Most of the spine surgeons preferred MD over ED, preference being homogeneous across all lumbar pathologies. In ED, the interlaminar approach was preferred more frequently than the transforaminal approach. The most commonly chosen contraindication for the interlaminar approach and transforaminal approach was ≥ 3 levels lumbar disc herniation (LDH) (n = 117, 73.1%) and calcified LDH (n = 102, 63.8%), respectively. There was no significant association between the type of approach preferred (MD vs. ED; and interlaminar vs. translaminar endoscopic approach) with the type of workplace and the level of experience. Conclusion: Spine surgeons were inclined toward MD over ED, due to various reasons, such as a steep learning curve, lack of training opportunities, and upfront expenses. There is a pressing need for the upliftment of ED in LMICs which requires global action.

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Section: Discussionmentioning

confidence: 99%

Endoscopic versus microscopic discectomy for pathologies of lumbar spine: A nationwide cross-sectional study from a lower-middle-income country

Pahwa,

Tayal,

Chowdhury

et al. 2023

Journal of Craniovertebral Junction and Spine

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“…In some circumstances, additional surgery may be required to treat underlying cause of PSSS. Patients with psychological symptoms may benefit from psychotherapy, medication, or other psychological therapies [15][16] . Radiological investigations remain a cornerstone of PSSS assessments.…”

Section: Introductionmentioning

confidence: 99%

“…Previously, X-rays and CT scans were the investigation of choice, but now MRI is the standard. Gadolinium-enhanced T1-weighted images enable the distinction between disc herniation and postsurgical fibrosis [16][17][18] .…”

Section: Introductionmentioning

confidence: 99%

Incidence of neurological deficits of post spinal surgery syndrome

Haq¹,

Ali

Mehmood

et al. 2023

ijhs

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Background: Post spinal surgery syndrome (PSSS) is characterized by chronic discomforts post one or more spine operations. Despite advancements in surgical technology, failure rate of back operations has not decreased. These conditions may occur preoperatively, intraoperatively, and postoperatively. Objectives: The primary purpose of this investigation was to ascertain the incidence and causes of neurological complications in patients who have undergone spinal surgery and subsequently developed PSSS. Methods: Cross sectional research was performed at Mardan Medical Complex, Mardan, comprising 82 patients (50 males and 32 females). X-ray studies, MRI, and electromyography was the tool for initial lumbar surgery to confirm the initial diagnosis. Participants were requested to submit the questionnaire and then, their scores were calculated and analyzed as per standard protocols. Results: The potential causes of PSSS, indicated 16 (19.5%) patients with incorrect diagnosis, 24 (29.3%) of the due to surgical technical errors, 10 (12.2%) due to improper pre-operative patient selection and 20 (24.4%) as a result of recurrent disc herniation after surgery. The frequency of cases of complications was spinal fusion (64.09%), followed by kinesiophobia (47.38%), laminectomy (45.98%), depression (40.3%), numbness in lower limbs (36.9%), myelopathy (14.5%) and other neurological deficits (12.56%).

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Efficiency of Lidocaine Intramuscular and Intraosseous Trigger Point Injections in the Treatment of Residual Chronic Pain after Degenerative Lumbar Spinal Stenosis Decompression Surgery

Al-Zamil,

Kulikova,

Shnayder

et al. 2024

JCM

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Introduction: Despite the long-term use of intramuscular and intraosseous lidocaine trigger point injections (LTPI) in the treatment of patients with low back pain, there have been no studies examining their efficiency in treatment of residual pain after degenerative lumbar spinal stenosis (DLSS) decompression surgery. The purpose of our research is to examine the LTPI efficiency in the treatment of residual lumbar pain after DLSS decompression surgery and to compare the analgesic and recovery effects of intramuscular and intraosseous LTPI administered in the L4–S1 region and in the posterior superior iliac spine (PSIS) after treatment and during four months of follow-up. Materials and Methods: We observed 99 patients (F:50, M:49) aged 42 to 59 years with residual neurological disorders after DLSS decompression surgery. In all patients, the pain syndrome exceeded 6 points on the VAS and averaged 7.2 ± 0.11 points. The control group (n = 21) underwent only pharmacotherapy. In addition to pharmacotherapy, the LTPI group underwent intramuscular LTPI in L4–S1 (n = 20), intramuscular LTPI in the PSIS (n = 19), intraosseous LTPI in L5, S1 (n = 20), and intraosseous LTPI in the PSIS (n = 19). A neurological examination was carried out before treatment, 7 days after completion of treatment, and at the end of the second and fourth months of the follow-up period. Results: In the control group, intramuscular LTPI in L4–S1 subgroup, intramuscular LTPI in PSIS subgroup, intraosseous LTPI in L5, S1 subgroup, and intraosseous LTPI in PSIS subgroup, the severity of pain decreased after treatment by 27.1% (p ≤ 0.05), 41.7% (p ≤ 0.01), 50.7% (p ≤ 0.01), 69% (p ≤ 0.01), and 84.7% (p ≤ 0.01), respectively, and at the end of the second month of follow-up, by 14.3% (p > 1), 29.2% (p ≤ 0.05), 38% (p ≤ 0.01), 53.5% (p ≤ 0.01), and 72.2% (p ≤ 0.01), respectively. Reduction of neurogenic claudication, regression of sensory deficit, increase of daily step activity, and improvement of quality of life after treatment were noted in intramuscular LTPI subgroups by 19.6% (p ≤ 0.05), 36.4 (p ≤ 0.05), 40.3% (p ≤ 0.01), and 21.0% (p ≤ 0.05), respectively, and in interosseous LTPI subgroups by 48.6% (p ≤ 0.01), 67.4% (p ≤ 0.01), 68.3% (p ≤ 0.01), and 46% (p ≤ 0.01), respectively. Conclusions: LTPI is highly effective in the treatment of patients with residual pain after DLSS decompression surgery. High analgesic effect, significant regression of sensory deficits and gait disorders, and remarkable improvement of daily step activity and quality of life are noted not only after the end of LTPI treatment but also continue for at least 2 months after treatment. Intraosseous LTPI is more effective than intramuscular LTPI by 92%, and LTPI in PSIS is more effective than LTPI in L4–S1 by 28.6%.

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The post spinal surgery syndrome

Cited by 7 publications

References 43 publications

Endoscopic versus microscopic discectomy for pathologies of lumbar spine: A nationwide cross-sectional study from a lower-middle-income country

Endoscopic versus microscopic discectomy for pathologies of lumbar spine: A nationwide cross-sectional study from a lower-middle-income country

Incidence of neurological deficits of post spinal surgery syndrome

Efficiency of Lidocaine Intramuscular and Intraosseous Trigger Point Injections in the Treatment of Residual Chronic Pain after Degenerative Lumbar Spinal Stenosis Decompression Surgery

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