Failed Back Surgery Syndrome in Lomber Disc Herniation: The Retrospectıve Analysis of Success Scorings of Epidural Fibrosis and Recurrent Cases in Reoperations

Aim: In this work, failed back surgery syndrome(FBSS) which observed in Lomber disc herniation(DH) postoperatively is analysed; and especially epidural fibrosis and recurrent cases are retrospectively analysed through calculating the success scores.
Method: Our work had been carried out between January/2000 – December/2006. In our clinic, 1268 cases in total were examined that were operated by reason of lomber disc herniation in our clinic. Among the cases that were included to the study, the 70 were evaluated as FBSS and the radiological evidences, surgical and clinical findings were analysed retrospectively.
Result: Of all the patients 36 were women (51%), the 34 were male (48.6 %). Their ages changed between 22-74 and the age average was found as 49.9. Of all the reoperated cases; the 45 (64%) were reoperated by reason of recurrent DH, 9 (12.8%) epidural fibrosis and recurrent DH, 8 (11.4% ) paraspinal abse, 3 (4.2%) lomber stenosis, 3 (4.2%) foraminal stenosis, 1 (1.4%) postoperative discitis, 1(1.4%) Cerebro spinal fluid (CSF) fistule. While the success rate of the cases with epidural fibriosis was found as 37.2 % ; 75.9% success rate was recorded for the patients with recurrent DH. Statistical comparison was found as meaningful. (p< 0.05)
Conclusion: The most frequent reoperation cause for the patients who were operated by reason of lomber DH is the recurrent herniations which occur at the same level; the same side or the opposite side. The cases with epidural fibriosis must be well-assessed radiologically and clinically and the most effective treatment plan should be aimed and formed.