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Analysis of reasons for failed surgery treatment in patients with back pain

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Fifty-three patients followed up for back pain and operated on are analyzed. The failed back surgery syndrome was observed in 47% of cases. Surgical results did not depend on the duration of the last exacerbation, the frequency of admissions, the presence of radicular syndrome, the size of intervertebral hernias, and the type of intervention (discectomy or microdiscectomy). Magnetic resonance imaging showed postoperative recurrent hernia in 50% of patients with good surgical results and in 89% of those with its poor results, which suggested that the surgical outcome could be only partially determined by a recurrence. Surgical treatment failures were correlated with the presence of neuropathic pain, anxiety, and depression. The detection of the neuropathic and psychogenic components of pain syndrome and the use of combination therapy with antidepressants and anticonvulsants for back pain will reduce the number of surgical interventions and improve their results.

About the Authors

M. S. Kokina
Polyclinic One Hundred and Ninety-Two, South Administrative District
Russian Federation

E. G. Filatova
I.M. Sechenov First Moscow Medical University
Russian Federation

Department of Nervous Diseases



1. <div><p>Болевые синдромы в практике. Под ред. А.М. Вейна М.: МЕДпресс-информ, 2001;368 с.</p><p>Gatchel R.J., Gardea M.A. Lower back pain: psychosocial issues. Their importance in predicting disabiliti, response to treatment and search for compensation. Nevrol clin 1999;17:149-66.</p><p>Яхно Н.Н., Штульман Д.Р. Болезни нервной системы. Т.1. М.: Медицина, 2005;107-23.</p><p>Гэлли Р.Л., Спайт Д.У., Симон Р.Р. Неотложная ортопедия. Позвоночник. М.: Медицина, 1995;432 с.</p><p>Rommel O., Maercklin A., Eichbaum A. et al. Hemisensory impairment in neuropathic pain following chronic radiculopathy. Schmerz 2005;19(1):59-64</p><p>Борзунов А.А. Анализ рецидивов и хирургическая профилактика осложнений грыж межпозвонковых дисков на поясничном уровне: Автореф. дисс. ... канд. мед. наук. М., 2006;29 с.</p><p>Матвеев В.И., Глущенко А.В. Отдаленные результаты хирургического лечения грыж межпозвонковых дисков поясничного отдела позвоночника. Боль 2005;3:41-4.</p><p>Штульман Д.Р., Попелянский Я.Ю. Заболевания переферической нервной системы. В кн.: Болезни нервной системы. Под ред. Н.Н. Яхно. Т.1. М.: Медицина, 1995;394-545.</p><p>Подчуфарова Е.В., Яхно Н.Н. Боль в спине. М.: ГЭОТАР-Медиа, 2010;368 с.</p><p>Толпекин EJL, Олешкевич Ф.В. Отда- ленные результаты дискэктомии при гры- жах поясничных межпозвонковых дисков. Нейрохирургия 2006;3:33-7</p><p>Cadoux-Hudoson T.A.D. A Manual for European Trainees in Neurosurgery. In: Fail Back Surgery Syndrome. 1996;767.</p><p>Гельфенбейн М.С. Международный конгресс, посвященный лечению хронического болевого синдрома после операций на поясничном отделе позвоночника «Pain Management 98» (Failed Back Surgery Syndrome). Нейрохирургия 2000;1-2:65.</p><p>Кузнецов И.В., Черненко О.А. Послеоперационные люмбоишиалгии (люмбалгии). Вертеброневрология 2006;3-4 (13):117-8</p><p>Carragee E.J., Han M.Y., Suen P.W. et al. Clinical outcomes after lumbar discectomy for sciatica: the effects of fragment type and anular competence. J Bone Joint Surg Am 2003;85:102-8.</p><p>Koes B.W., van Tulder M.W., van der Windt W.M. et al. The efficacy of back schools: a review of randomized clinical trials. J Clin Epidemiol 1994;47:851-62</p><p>Saruhashi Y., Mori K., Katsuura A. et al. Evaluation of standard nucleotomy for lumbar disc herniation using the love method: results of follow up studies after more than 10 years. Eur Spine J 2004;13:626-30.</p><p>Helthoff K.B., Burton C.V. CT evaluation of the failed back surgery syndrome. Orthop Clin North Am 1985;16-15:417-44.</p><p>Porter R.W. Spinal surgery alleged medical negligence. J R Coll Surg Edinb 1997;2:376-80.</p><p>Rodngues F.F., Dossa, D.C., Oliveira C.R. Castro Failed back surgery syndrome: casuistic and etiology. Arq Neuro-Psiquiatr 2006;64:757-61.</p><p>Острова К.А. Факторы риска и причины рецидива болевого синдрома при операциях на поясничных межпозвонковых дисках. Автореф. дисс. ... канд. мед. наук. М., 2010;21 с.</p></div><br />


For citations:

Kokina M.S., Filatova E.G. Analysis of reasons for failed surgery treatment in patients with back pain. Neurology, Neuropsychiatry, Psychosomatics. 2011;3(3):30-34. (In Russ.)

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ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)