Failed Back Surgery Syndrome: Etiology and the Results of the Treatment

Kim, Byung Jik; Cho, Jin Tai; Shin, Dong Hwan; Kim, Jin Ho

Abstract

STUDY DESIGN: We retrospectively analyzed 26 cases of failed back surgery syndrome.
OBJECTIVE
To reveal the cause of failure, to analyze the results of treatment and to report how to prevent failure. SUMMARY OF LITERATURE REVIEW: The trend term failed back surgery syndrome(FBSS) is used to describe a heterogenous group of patients whose unifying factor is a persisting complaint of back and leg pain. FBSS is a serious problem to both patient and surgeon, and incidence is about 10-15 percent. MATERIALS AND METHOD: Twenty-six patients, who diagnosed as FBSS were followed up for 28 months on an average from 1994 to 1997. We analyzed cause of failure, treatment modalities and results of treatment. Clinical result was evaluated by Kirkaldy-Willis criteria.
RESULTS
The causes of FBSS were recurred disc(9 cases), spinal stenosis(7 cases), epidural fibrosis(4 cases), segmental instability(2 cases) infection(2 cases), hematoma and worker's compensation(1 case each). The clinical results were good in case of recurved disc and having symptom free interval more than 6 months. According to kirkaldy-willis criteria, excellent and good results were in 18 cases of 26 cases and most of excellent results were obtained from recurred disc and combined spinal stenosis.
CONCLUSION
Removal of mechanical cause and decompression were the most commonly used treatment modalities and posterolateral or anterior fusion was performed when instability was suspected.