요추간판탈출증 수술실패 증후군 환자의 임상 및 전기진단학적 소견

Abstract

Objective: To analyze the clinical and electrodiagnostic findings of patients with failed back surgery syndrome after lumbar disc operation. Method: We investigated 28 patients with back and/or lower limb pain and weakness who were underwent lumbar spine operation. Seven patients who had undergone surgery due to spinal infection or fracture were excluded. Twenty-one patients included 7 female and 14 male patients with ages 20∼63 years, and the mean age was 44.4 years. The following data were evaluated: clinical symptoms, neurological examination, duration from operation to first visit, preoperative diagnosis, operation number and site, electrodiagnostic studies, radiologic studies (simple radiographs, epidurography, CT, MRI), and psychological evaluations (SCL-MPD).

Results: The time of the visit after the operation varied between one month and 15 years (mean 48.5 months). Electrodiagnostic study revealed lumbar radiculopathy in 18 patients and the most common level was at the fifth lumbar root. All eight patients who undergone epidurography showed filling defect or indentation. Psychologic evaluations were performed on five patients and they revealed high scores in depression and somatization. Conclusion: Clinical and electrodiagnostic findings of lumbar radiculopathy, abnormal epidurographic findings and psychological results after lumbar disc operation were related to the causes of failed back surgery syndrome.