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Failed back surgery syndrome is a postsurgical phenomenon that involves persistent low back pain following one or more spinal surgeries. The multidisciplinary approach to its management includes both conservative and surgical treatments. Anterior lumbar interbody fusion (ALIF) has stood out as a surgical option for refractory pain. We present five cases of patients with failed back surgery syndrome treated with ALIF. These patients demonstrated reduced pain scale scores and significant improvement in functional capacity after the application of the abovementioned technique, suggesting its effectiveness in this group of patients who are refractory to conservative treatments. It should be noted that previous studies supporting the usefulness of ALIF mention the importance of careful patient screening, considering both preoperative factors (pain pathophysiology and accurate assessment of the underlying cause) and postoperative factors (pain recurrence and biomechanical changes), to ensure the success of the technique. Therefore, while ALIF appears to be a promising surgical option for these patients--whose condition is challenging--the need for further studies with larger samples is highlighted to provide stronger scientific evidence supporting its efficacy for this condition. [ABSTRACT FROM AUTHOR]

Introduction: Perception and relief of pain exhibit variability among individuals. Age, gender, ethnicity, educational level, actual stress level, mood, or medical conditions can modify the personal interpretation of pain and responses to pharmacological treatment. These differences may play a significant role in the effects, sometimes unwanted, of analgesic treatment. Objectives: Define patient typologies with Failed Back Syndrome regarding attitudes toward the disease, treatment, healthcare, and the follow-up they receive from their healthcare professionals. Create a tool for patient profile identification. Materials and Methods: A clinical case series study, observational, descriptive, and cross-sectional. Study population: patients from the Pain Unit of Nuestra Señora de La Candelaria University Hospital (HUNSC) in Tenerife, conducted in three phases: collection of medical history data (F0), initial visit (F1), and personal interview (F2). Results: Five patient typologies are obtained based on responses to 17 items. Regression equations are calculated from these responses to predict the patient type. They are grouped into “Classics,” “Dependents,” “Critics,” “Unconscious,” and “Responsible.” Additionally, two tools with 17 items and another with 7 optimized items are developed to simplify the process. Conclusions: These tools enable Community Pharmacy (CP) to identify patients based on their characteristics to direct personalized strategies for each of them. [ABSTRACT FROM AUTHOR]

Spinal cord stimulation (SCS) is an electrical neuromodulation technique in which one or more electrodes are placed in the epidural space of the spine1. The International Neuromodulation Society describes this neurostimulation technique as safe, reversible, and effective at relieving pain in failed back surgery syndrome and improving function and overall quality of life. However, patient selection is of utmost importance to outcomes, and neuromodulation does have recognized risks and complications, although very rarely do complications result in long-term morbidity or mortality1-4. Hardware-related complications are more common than biologic complications, with lead related complications, including migration and fracture, most frequently. Biological complications most commonly include superficial infection and pain on the implant site2-5. A close follow up is important to detect and prevent such complications and to minimize its impact. We present a case of thoracic back pain after implantation of a SCS device due to failed back surgery syndrome. We therefore describe the diagnostic process undertaken to rule out any possible complications related to this technique, leading to the finding a new problem: a vertebral fracture, which was deemed not to be related to the implantation of the SCS. [ABSTRACT FROM AUTHOR]

The epidural adhesiolysis or lysis with pulsed radiofrequency catheter has its main indication in the radiculopathies sequel of failed surgery of column. Allows the realization of pulsed radiofrequency to root level and also affected the possibility of breaking up adhesions that may exist to epidural level. Also currently being used in other indications to access more easily and proximal to the node of the root (neuralgias postherpeticas rebels...). [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction. Failed back surgery syndrome may be secondary to surgery or due to a preexisting degenerative disease. Magnetic resonance with gadolinium helps to evaluate post-surgical changes in the epidural space and in the rachidian canal, as well as persistence or recurrence of a spinal disc herniation. Objective. Show the usefulness of magnetic resonance to evaluate,the causes observed in patients with failed back surgery syndrome. Material and methods. The most representative cases treated at our center with a 1.5 Tesla resonator were chosen. Discussion. Magnetic resonance with gadolinium is used to evaluate patients with failed back surgery syndrome. The most common causes of this syndrome are: persistent or recurrent spinal disc herniation, arachnoiditis, epidural fibrosis, and spondylodiscitis, among others. It is important to know the type of surgery and time of evolution because the findings will not be the same at one week as they will at 6 months. Conclusion. Magnetic resonance is the best method to evaluate changes from back surgery, mainly to differentiate between epidural fibrosis and persistent or recurrent spinal disc herniation, the most common complications in failed back surgery syndrome. [ABSTRACT FROM AUTHOR]

The spinal cord stimulation, is an alternative in the management of chronic pain, mainly in failed back surgery syndrome, complex regional pain syndrome which performed in selected patients in an appropriate manner gives good results. Objective: determinate the efficacy of spinal cord stimulation on the pain control, quality of life of patients and their degree of reintegration into a full life style, as well as the risks of using this device. Material and methods: it was an open, prospective, longitudinal, and comparative study. It was performed in the Neurosurgical department at Centro Medico Nacional 20 de Noviembre ISSSTE, from March 2007 to July 2008. There were including ten patients with Failed Back surgery syndrome (7 patients), complex regional pain syndrome (2 patients) and spinal arachnoiditis (1 patient) diagnosis. patients were evaluated with a high therapeutic value, highly effective. In our sample there is a significant clinical improvement and statistically significant on the scales made. Visual analogue scale, McGill pain questionnaire, Hamilton depression scale and quality of life scale SF-36. The procedure was safe and there were no complications. It's necessary to have an adequate selection of the patients chosen for this treatment, because patients with an important psychoaffective disorder or who have a somatoform disorder do not present an adequate response up to this therapy. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)