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Persistent Postoperative Pain:
- Persistent postoperative pain symptoms can be consequence of inappropriate diagnosis , poor choice of intervention, inadequate intervention, or surgical complications.
- A large series by Burton et al in 1981 composed of an interinstitutional study on the failed back surgery syndrome (FBSS) determined that failure to recognize or adequately treat lateral stenosis of the lumbar spine intraoperatively, with resultant nerve irritation and compression comprised the primary etiology in 57% to 58% of patients and was responsible for 7-14% of failures. Other common causes were recurrent or persistent disk herniation which was evident in 12-16% of patients, lumbosacral adhesive arachnoiditis in 6-16%, and epidural scar in 6-8% were also prominent features.
- Intraoperative neural injury, mechanical pain, pseudarthrosis (failure of fusion), and operation on the wrong side or wrong level were implicated in less than 5% of failures.
- Conclusion: Although the complication rate of lumbar surgery is low, it can result in a new or persistent symptoms of back or leg pain.
Reference: Causes of failure of surgery on the lumbar spine.
Burton et al. Clin Orthop Relat Res. 1981 Jun;(157):191-9
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Last Updated on Wednesday, 18 January 2012 14:55 |
