Failed Back Surgery Syndrome에서 만족스러운 치료 결과에 영향을 주는 요인들

The Factors Affecting the Favorable Outcomes in the Treatment of the Failed Back Surgery Syndrome

Objective : The authors retrospectively analysed the factors affecting the favorable outcomes in the treatment of the Failed Back Surgery Syndrome(FBSS) or six years. Method : From March 1991 to December 1996, seventy-five patients were diagnosed as FBSS and its incidence was 3.4% of admitted patients with back pain in our department. We analysed the demographic data, etiologies, clinical menifestations, outcomes according to methods of operation, numbers of previous surgery, and time intervals between initial operation and final operation. Result : The most common etiology and previous surgical method of FBSS were insufficient surgery(54.7%) and partial laminectomy(53.3%). Patients were managed as followings ; Total laminectomy and spinal fusion with instrument in 41 cases(54.7%), total laminectomy without fusion in 23 cases(30.7%), and only partial laminectomy in 11 cases(14.7%). The overall treatment outcome was satisfactory in 48 cases(64%). Satisfactory results were observed in those patients who were treated by spinal fusion after complete laminectomy(34 cases), who had underwent only one operation previously(45 cases), and when the time interval between the initial operation and reoperation is shorter than 12 months(43 cases). Conclusion : The treatment outcome in FBSS was favorable in cases of the complete total laminectomy and spinal fusion with instrument, only one previous back surgery, and short time interval between initial and final operations.