Failed back surgery syndrome: casuistic and etiology

Arquivos de Neuro-Psiquiatria

Flávio Freinkel Rodrigues²  Diego Cassol Dozza¹  Claudio Russio De Oliveira¹  Ricardo Gomes De Castro¹ 

[1] ,Universidade Federal do Rio de Janeiro Faculdade de Medicina Serviço de Neurocirurgia

关键词: failed back surgery syndrome;    back pain;    spinal stenosis;    recurrent disc herniation;    discectomy;    epidural fibrosis;    síndrome pós-laminectomia;    lombalgia;    estenose de canal lombar;    hérnia de disco recorrente;    discectomia;    fibrose epidural;   

DOI  :  10.1590/S0004-282X2006000500011

来源: SciELO

【 摘 要 】

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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