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Failed back surgery syndrome

Jin-Gyu Choi, Sang-Woo Ha, Byung-Chul Son
OBJECTIVES: The authors investigated the difference in clinical outcome and the position of paddle lead spinal cord stimulation (SCS) between three-column and five-column paddle lead SCS in patients with FBSS. MATERIALS AND METHODS: In 21 patients who underwent paddle lead SCS at T9 (three-column, n = 9; five-column, n =12) for FBSS, a 12-month follow-up numerical rating scale, percent pain relief, and CT assessment of contact angle and percent reduction of T9 canal area were investigated...
October 12, 2016: World Neurosurgery
Ciara Clancy, Alison Quinn, Fiona Wilson
PURPOSE: Four to fifty percent of patients will develop Failed Back Surgery Syndrome (FBSS) following lumbar spine surgery. Repeated surgeries lead to escalating costs and subsequent decreases in success rate. Much of the research to date has focused on the psychosocial factors associated with FBSS. All factors including physical and pathological aetiologies should be examined. These factors may be independent, co-exist with or predispose patients to the psychological factors associated with FBSS...
September 23, 2016: Journal of Back and Musculoskeletal Rehabilitation
Jen-Chung Liao, Ping-Yeh Chiu, Wen-Jer Chen, Lih-Hui Chen, Chi-Chien Niu
BACKGROUND: In Taiwan, the life expectancy of an 80-year-old man is 88.4 years and the life expectancy of an 80-year-old woman is 89.8 years. Some of these people will develop symptomatic degenerative lumbar diseases that interfere with an active lifestyle. These older surgical candidates usually ask the surgeon whether it would be safe to undergo surgery. However, there is no literature assessing the outcomes of laminectomy, fusion and posterior fixation for degenerative lumbar diseases in patients older than 80 years...
2016: BMC Musculoskeletal Disorders
David Pang
INTRODUCTION: Chronic pain in children has been an under-recognized problem compared to adult pain. The aim of management is to help children and their families cope with the symptoms rather than a cure. Current medical treatments to reduce pain intensity are often short lived, poorly tolerated or ineffective. RESULTS: The use of electrical stimulation to treat pain is the current basis of modern Neuromodulation at the spinal cord and has been well established as spinal cord stimulation in adult practice...
August 9, 2016: European Journal of Paediatric Neurology: EJPN
Ashraf Eskandr, Sadik Abdel Maseeh
Purpose. Failed back surgery syndrome is a chronic pain condition requiring rapid, effective, and efficient management. This study evaluates the effect of adding dexmedetomidine to lumbar epidural steroids in patients with failed back surgery syndrome. Methods. Fifty patients suffering from failed back surgery syndrome were randomly assigned to one of two groups, receiving an epidural injection of 20 mL of either a mixture of betamethasone (14 mg) and bupivacaine 0.5 mg (group C) or a mixture of betamethasone (14 mg), bupivacaine 0...
2016: Anesthesiology Research and Practice
Samiul Muquit, Ahmad Abdelhai Moussa, Surajit Basu
Failure of spinal cord stimulation (SCS) may be due to hardware problems, migration of electrodes and, in the long-term, plasticity in the spinal cord with habituation to the stimulation current. We describe a series of seven patients who experienced acute therapeutic loss of SCS effects following an acute nociceptive event unrelated to primary pathology. There were no hardware problems. We called this 'Pseudofailure', as the effective stimulation returned in all patients following a period off stimulation or reprogramming...
May 2016: British Journal of Pain
S M Krieg, B Meyer
BACKGROUND: Post-nucleotomy syndrome includes all existing sequelae after surgical nucleotomy for the resection of a lumbar disc herniation, such as axial lumbar back pain and persisting radiculopathy. OBJECTIVES: To describe underlying pathologies and to determine operative treatment options. MATERIALS AND METHODS: Extensive literature research was carried out on Medline. RESULTS: Various devices and approaches have been developed in the last decades...
September 2016: Der Orthopäde
V Tronnier
Unfortunately, 10-40 % of patients still experience pain after spinal surgery. There are many reasons for the patients' complaints. If no identifiable cause, such as a recurrent disc herniation, is visible, this is referred to as failed back surgery syndrome. However, this definition includes a variety of possible underlying causes of the pain, which result in just as many different therapeutic approaches. In addition to pharmacological, behavioral and physical therapy, also neuromodulation techniques can be offered; the best known method is spinal cord stimulation (SCS)...
September 2016: Der Orthopäde
Hans-Raimund Casser
Failed back surgery syndrome (FBSS) is a frequent complication (15-40 %) of lumbar disc surgery and is rarely successfully treated by surgery with the exception of a re-prolapse associated with radicular pain. Multimodal pain treatment, however, is indicated by a lack of pathoanatomical correlates, unclear cause and psychosocial risk factors.This review describes a standardized non-operative treatment starting with broad interdisciplinary clarification by medical, psychological and physiotherapeutic means (assessment)...
September 2016: Der Orthopäde
A S Nikitin
This review provides current data on the failed back surgery syndrome (FBSS) of lumbar degenerative disease. The full range of complications forming this term is described. The data on the frequency and risk factors of various forms of FBSS are presented. General symptoms and diagnosis of the main FBSS forms are described. The questions of prevention and treatment of FBSS are considered.
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Kliment Gatzinsky, Roald Baardsen, Hendrik P Buschman
OBJECTIVE: To evaluate the effectiveness and safety of percutaneous octapolar (8-contact) leads in spinal cord stimulation (SCS) treatment of failed back surgery syndrome (FBSS) patients who have not reached their therapy goals with other treatment interventions. METHODS: Our prospective, multicenter, open-label, nonrandomized study included 93 patients ≥ 18 years of age suffering from chronic (≥ 6 months), intractable pain predominantly in the legs. Patients implanted with octapolar lead(s) and a neurostimulator after a successful test trial were followed for 12 months...
July 20, 2016: Pain Practice: the Official Journal of World Institute of Pain
Ahmed Kashkoush, Nitin Agarwal, Erin Paschel, Ezequiel Goldschmidt, Peter C Gerszten
INTRODUCTION: The development of adjacent-segment disease is a recognized consequence of lumbar fusion surgery. Posterior dynamic stabilization, or motion preservation, techniques have been developed which theoretically decrease stress on adjacent segments following fusion. This study presents the experience of using a hybrid dynamic stabilization and fusion construct for degenerative lumbar spine pathology in place of rigid arthrodesis. METHODS: A clinical cohort investigation was conducted of 66 consecutive patients (31 female, 35 male; mean age: 53 years, range: 25 - 76 years) who underwent posterior lumbar instrumentation with the Dynesys Transition Optima (DTO) implant (Zimmer-Biomet Spine, Warsaw, IN) hybrid dynamic stabilization and fusion system over a 10-year period...
2016: Curēus
Ivano Dones, Luca Zanin, Ines Marongiu, Vincenzo Levi, Luisa Chiapparini, Michele Rizzi
BACKGROUND: The efficacy of epidural spinal cord stimulation on chronic neuropathic pain due to failed back surgery syndrome or nerve root lesions is well reported. There is even literature reporting the effects of spinal cord stimulation in controlling peripheral vascular lesions as in peripheral arteriopathies or diabetic neuropathies and in complex regional pain syndrome type II. This is probably due to an effect of epidural spinal cord stimulation, mainly on the parasympathetic nervous system...
September 2016: World Neurosurgery
Shohei Ise, Koki Abe, Sumihisa Orita, Tetsuhiro Ishikawa, Kazuhide Inage, Kazuyo Yamauchi, Miyako Suzuki, Jun Sato, Kazuki Fujimoto, Yasuhiro Shiga, Hirohito Kanamoto, Masahiro Inoue, Hideyuki Kinoshita, Kazuhisa Takahashi, Seiji Ohtori
BACKGROUND: Far-out syndrome was reported by Wiltse et al. in 1984, which is a condition characterized by L5 spinal nerve radiculopathy due to nerve compression between the L5 transverse process and sacral alar. Although many cases of far-out syndrome have been reported, to our knowledge, the present case firstly showed far-out syndrome due to assimilated L4 hemivertebra and L5 vertebra through which abnormal nerve root passed. CASE PRESENTATION: A 71-year-old man presented with left lower back pain and intermittent claudication accompanied by severe left buttock pain...
2016: BMC Research Notes
W Käfer, I Heumüller, N Harsch, C Kraus, W Reith
STANDARD PROCEDURE: As a rule, postoperative imaging is carried out after spinal interventions to document the exact position of the implant material. INFORMATION: Imaging is absolutely necessary when new clinical symptoms occur postoperatively. In this case a rebleeding or an incorrect implant position abutting a root or the spinal cord must be proven. In addition to these immediately occurring postoperative clinical symptoms, there are a number of complications that can occur several days, weeks or even months later...
August 2016: Der Radiologe
Ali Yavuz Karahan, Nilay Sahin, Akın Baskent
BACKGROUND: Failed back surgery syndrome (FBSS) is a condition characterized by persistent pain following back surgeries. OBJECTIVE: To determine the effects of different exercises programs in FBSS. METHODS: A Single-blind, randomized, controlled trial designed. One hundred participants with failed back surgery syndrome were randomly assigned to three different exercises groups (Isokinetic, Dynamic lumbar stabilization (DLS), and home exercises (HE) groups) and a control group...
June 17, 2016: Journal of Back and Musculoskeletal Rehabilitation
Jinyoung Oh, Daehyun Jo, Koohyun Kim, Jungwoo Shim, Misun Roh
UNLABELLED: Lumbar spinal stenosis is one of most common pathologic conditions affecting the lumbar spine. Pain and/or disability in the low back and lower extremities with or without neurogenic claudication may occur as a result of compression of dural sac contents or nerve roots in the narrowed space. Bulging and protrusion, facet joint hypertrophy, and disc herniation combined with osteophytes and arthritic changes of facet joints can be the cause of lumbar spinal stenosis. Medical/interventional treatment may be considered as an initial treatment for patients with mild symptoms of lumbar spinal stenosis...
May 2016: Pain Physician
Mert Akbaş, Mehmet Arif Yeğin, İrem Özdemir, Ethem Göksu, Mahmut Akyüz
Spinal cord stimulation as treatment of chronic low back pain via neuromodulation has been frequently performed in recent years. The dorsal column is stimulated by an electrode placed at the epidural region. In the case presently described, subcutaneous lead was implanted in a patient with failed back syndrome after spinal cord stimulation was inadequate to treat back and gluteal pain. A 65-year-old male had undergone surgery to treat lumbar disc herniation, after which he received physical therapy and multiple steroid injections due to unrelieved pain...
January 2016: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
Semra Işik, Baran Yilmaz, Murat Şakir Ekşi, Emel Ece Özcan-Ekşi, Akin Akakin, Zafer Orkun Toktaş, Mustafa Kemal Demir, Deniz Konya
In this case-based review, the authors analyzed relevant literature with an illustrative patient of theirs about subdural hematoma secondary to dural tear at spinal surgery. Intracranial hypotension is a condition of decreased cerebrospinal fluid volume and pressure. Even though intracranial hypotension is temporary and can be managed conservatively, it may progress and result in subdural fluid collections, hematoma formations, "brain sagging or slumping" states, syringohydromyelia, encephalopathy, coma, and even death...
June 2016: Journal of Craniofacial Surgery
Saiyun Hou, Kenneth Kemp, Martin Grabois
BACKGROUND: Traditional tonic spinal cord stimulation (SCS) has been approved by FDA for chronic pain of intractable back and limb pain. However, it induces paresthesia and relieves pain poorly to some extent. Recently, burst SCS has been developed for pain reduction without the mandatory paresthesia. STUDY DESIGN: A systematic review of burst SCS for chronic back and limb pain. OBJECTIVE: The objective of this systematic review is to determine the effects of burst SCS on pain relief without paresthesia for various conditions including failed back surgery syndrome, painful diabetic neuropathy, and radiculopathy...
June 2016: Neuromodulation: Journal of the International Neuromodulation Society
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