engleski

FAILED BACK SURGERY SINDROME &#8211 ; CLINICAL REPORT

Introduction: Results of surgery for lumbar herniated disc, in terms of pain relief and capacity to work, are good ranging from 80% to 95% of cases. Still, there are patients who after lumbar disc surgery have persistent low-back and radicular pain &#8211 ; Failed Back Surgery Syndrome. Patients and Methods: We retrospectively reviewed 1620 patients surgically treated (microdiscectomy) in 5-years period (01.01.1995-01.01.2000) to determine rate of reoperations and causes for reoperation. Results: Out of 1620 operated patients during follow up ranged from 6 to 66 months, 155 were reoperated (9, 56%) because of FBSS.40 of reoperated patients were operated in other neurosurgical institutions which means that FBSS rate in our Department was 7, 27% in given period. Causes for reoperation were defined intraoperatively: residual disc (41.29%), adhesions (13, 54%), previous operation at the wrong level (4, 51%) and herniated disc at the new level (27, 1%). Rare causes for reoperations (13, 54%) were lateral recessus stenosis, spinal stenosis, pseudomeningocoelae and infections. True recurrence rate was 3, 3%. Conclusion: Results in this series are comparable with other reported in literature, and they not only depend on skill of the neurosurgeon but also on proper patient selection. Better neuroimaging and introduction of new techniques such as endoscopically assisted microdiscectomy could improve results.

herniated lumbar disc; microdiscectomy; failed back surgery syndrome

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