Outcome Of Surgical Treatment Of Failed Back Surgery Syndrome

Objective To report the postsurgical outcome after a redo spinal surgery of failed back surgery syndrome (FBSS).Methods We prospectively studied21patients with FBSS. The primary surgeries were open reduction and internal fixation of lumbar fracture (8cases), posterior decompression and internal fusion (10cases), and fenestration laminotomy and discectomy (3cases).21cases were all treated surgically. The revision procedure included hemilaminectomy or total laminectomy, discectomy, enlarged decompression of nerve root canal, internal fixation, posteriolateral or intervertebral fusion, and artificial vertebra replacement. The data about history, physical sign, image and exploration were reviewed. All cases were followed up routinely. Radiography, Oswestry Disability Index (ODI) and Visual analog scales (VAS) were used to evaluate the outcome of revision surgery.Results All patients with secondary operations were followed up from1to2years and obtained satisfactory outcomes with no neuroinjury noted. Radiography shows bone graft union in all cases without cages displacement, instrument failure and so on. The ODI was80.8±2.5and24.2±3.0for preoperation and follow-up respectively, which showed statistical significance between them(P<0.05), while the VAS back pain score was7.5±0.9and4.3±0.1for preoperation and follow-up respectively, the VAS leg pain score was7.6±1.9and5.4±1.5, which also showed statistical significance(P<0.05).Conclusions FBSS is a complication of back surgery manifesting as a syndrome with all kinds of factors and presents. Satisfactory outcome can be gained if the secondary operation is chosen properly. Anterior spinal re-operation is one of the effective procedures for failed back surgery syndrome after posterior open reduction and internal fixation of lumbar fracture.