• The Korean Journal of Pain
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• 제18권2호
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• pp.151-155
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• 2005

Background: A significant number of patients complain of persistent pain or neurologic symptoms after lower back surgery. It is reported that facet joint pain plays a role in failed back surgery syndrome. To the best of our knowledge, there are few studies that have investigated the outcome of radiofrequency neurotomy in the patients with failed back surgery syndrome. Methods: The study group was composed of thirteen patients who were operated on due to their low back pain, and they displayed no postoperative improvement. All the patients underwent double diagnostic block of the lumbar medial branch of the dorsal rami with using 0.5% bupivacaine. The patients who revealed a positive response to the double diagnostic block were then treated with percutaneous radiofrequency neurotomy. The effect on their pain was evaluated with using a 4 point Likert scale. Results: Eleven patients revealed a positive response to the double diagnostic block. Ten patients were given percutaneous radiofrequency neurotomy. Nine patients showed sustained pain relief for 3 months after the percutaneous radiofrequency neurotomy. Conclusions: We found lumbar facet joint syndrome in the patients with failed back surgery syndrome by performing double diagnostic block and achieving pain relief during the short term follow-up after percutaneous radiofrequency neurotomy of the lumbar zygapophysial joints. This suggested that facet joint pain should be included in failed back surgery syndrome.

• The Korean Journal of Pain
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• 제12권2호
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• pp.191-194
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• 1999

Background: Millions of patients with chronic sciatica are still treated with epidural corticosteroids. The efficacy of epidural corticosteroids remains questionable, especially in the failed back surgery syndrome (FBSS). We studied to evaluate outcome for 10 patients with failed back surgery syndrome treated with spinal nerve root block using corticosteroids, hyaluronidase, and local anesthetics. Methods: The affected nerve roots are localized with the help of fluoroscopy and contrast dye. Local anesthetic diluted in 1,500 U hyaluronidase and 40 mg methylprednisolone is injected. A small retrospective pilot group of 10 patients with FBSS was treated. The success rate is evaluated using a visual analogue scale at 1 week and 3 month interval after the last injection. Results: Initially, 7 patients experienced good pain relief; 5 patients suspained pain relief for 3 months. No complications were observed. Conclusions: This technique is worthwhile for patients with FBSS and where epidural fibrosis is suspected to be the pain origin.

• 척추신경추나의학회지
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• 제5권2호
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• pp.57-68
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• 2010

Objectives : The propose of this study is to find out the clinical application of conservative treatment for Failed Back Surgery Syndrome(FBSS) patients. Methods : We examined 3 patients with Failed Back Surgery Syndrome(FBSS) who visited Jaseng Hospital of Oriental Medicine. We used Acupuncture, Bee venom, CHUNA manual therapy, Herbal medication for this patient. And we measured of NRS score to evaluate the conservative treatment effects. Results : In this study, patients sciatica and symptoms has improved. NRS score were also decreased. Conclusions : Conservative oriental medical treatment can be effective for improving symptoms of Failed Back Surgery Syndrome.

• Journal of Yeungnam Medical Science
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• 제41권3호
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• pp.166-178
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• 2024

Amid the worldwide increase in spinal surgery rates, a significant proportion of patients continue to experience refractory chronic pain, resulting in reduced quality of life and escalated healthcare demands. Failed back surgery syndrome (FBSS) is a clinical condition characterized by persistent or recurrent pain after one or more spinal surgeries. The diverse characteristics and stigmatizing descriptions of FBSS necessitate a reevaluation of its nomenclature to reflect its complexity more accurately. Accurate identification of the cause of FBSS is hampered by the complex nature of the syndrome and limitations of current diagnostic labels. Management requires a multidisciplinary approach that may include pharmacological treatment, physical therapy, psychological support, and interventional procedures, emphasizing realistic goal-setting and patient education. Further research is needed to increase our understanding, improve diagnostic accuracy, and develop more effective management strategies.

• Journal of Korean Neurosurgical Society
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• 제30권6호
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• pp.734-742
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• 2001

Objective : To evaluate the role of anterior lumbar interbody fusion in treatment of failed back surgery syndrome, the authors retrospectively analyzed the result of anterior lumbar interbody fusion performed in our institute. Methods : Fifteen FBSS patients due to variable causes have been treated with anterior lumbar interbody fusion in our institute from April 1994 to June 1999. We analyzed clinical changes in 15 patients who were followed up for an average of 23 months. Results : The etiologies of FBSS were post operative discitis(6 cases), post operative instability(3 cases), post operative adhesion(5 cases), and recurrence(1 case). These fifteen FBSS patients were treated with anterior lumbar interbody fusion. The overall treatment outcome was satisfactory(excellent and good) in 11 cases. Three patients were slightly improved, but post operative low back pain was remained. One patient who had underwent nerve root injury due to pedicle screw insertion showed no improvement. Conclusion : We conclude that the anterior lumbar interbody fusion for FBSS seems to be safe and favorable treatment in selective patients, because low incidence of nerve injury risk and post-operative infection.

• Journal of Acupuncture Research
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• 제32권2호
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• pp.217-227
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• 2015

Objectives : This study is an evaluation of the effectiveness of treatments combined with Korean medical methods, such as relaxative Chuna and Gangchuk herbal medicines, for patients with failed back surgery syndrome. Methods : In this study, medical records of ten patients who experienced failed back surgery syndrome and participated in intensive Korean medical treatment were reviewed. All patients received relaxative Chuna and acupuncture along with Gangchuk herbal medicines during hospitalization. Numeric rating scale(NRS) in the degree of 0 to 10, pain-free walking distance(PFWD) and oswestry disability index(ODI) were measured before and after treatments. Results : The patients were hospitalized for an average of 22 days. The average NRS of lumbar pain in all patients decreased from $7.7{\pm}1.6$ to $3.2{\pm}2.2$ and the average NRS decline of leg pain was from $7.7{\pm}1.7$ to $3.2{\pm}2.2$, both of which indicate statistical significance(p < 0.05). PFWD in all patients increased from 113.3 m to 798.1 m on average. The average ODI in all patients significantly improved from $63.9{\pm}7.0$ to $43.9{\pm}6.9$(p < 0.05). Conclusions : The treatments combined with Korean medical methods for failed back surgery syndrome patients are clinically effective and viable.

• The Korean Journal of Pain
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• 제19권1호
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• pp.123-126
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• 2006

Spinal cord stimulation (SCS) has been used since 1967 for refractory chronic pain. SCS has recently undergone a variety of technical modifications and advances, and it has been applied in a variety of pain conditions. SCS has been most commonly applied for those patients with chronic back and leg pain and failed back surgery syndrome (FBSS). The clinical hallmark of FBSS is chronic postoperative pain. The pain pattern varies and the pain may show an axial or radicular distribution. Chronic intractable pain after FBSS is difficult to treat. This report describes our experience with treating chronic pain in two patients who suffered from FBSS with a spinal cord stimulator. A permanent spinal cord stimulator was implanted after a successful trial of stimulation with temporarily implanted electrodes. After 5 months of follow-up, the two patients had satisfactory improvement of their pain.

• 척추신경추나의학회지
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• 제6권2호
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• pp.23-32
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• 2011

본 논문은 3차례의 양방적 수술 치료를 받은 후에도 지속적으로 요통과 함께 하지 방사통을 호소하며 일상생활 수행에 장애가 따르던 70세 여환에 대한 증례로 침구치료, 약물치료, 추나치료, 봉약침치료 등의 한의학적 보존적 치료방법으로 통증의 감소와 함께 일상생활 능력 개선에 유의한 효과를 보였다. 향후 요추 추간판 탈출증 환자의 한방적 보존적 치료에 대한 보다 다양한 연구와 임상적 고찰이 이루어져야 한다고 사료된다.

• Korean Journal of Acupuncture
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• 제28권3호
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• pp.233-244
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• 2011

Objectives : To evaluate the effectiveness of direct moxibustion in patients with failed back surgery syndrome (FBSS). Methods : 5 patients (3 females and 2 males) with FBSS underwent direct moxibustion on ouch points (阿是穴) for 10 to 15 weeks (once a week). The effectiveness of the treatment was evaluated with NRS (numerical rating scale), ODI (Oswestry disability index), BDI (Beck depression inventory) score, SF-36 (short form 36 health survey) score and PSQI (Pittsburgh sleep quality index) before and after the treatment. Results : Within observation period, average value changed from 10.0 to 4.2 in NRS of pain, from 37.0 to 20.6 in ODI, from 20.6 to 12.0 in BDI score, 42.2 to 62.6 in SF-36 score, and from 8.6 to 5.2 in PSQI. Conclusions : Direct moxibustion on FBSS patients showed more or equivalent effectiveness when compared to conventional FBSS treatment modalities.

• The Korean Journal of Pain
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• 제27권1호
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• pp.3-15
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• 2014

As our population ages and the rate of spine surgery continues to rise, the use epidural lysis of adhesions (LOA) has emerged as a popular treatment to treat spinal stenosis and failed back surgery syndrome. There is moderate evidence that percutaneous LOA is more effective than conventional ESI for both failed back surgery syndrome, spinal stenosis, and lumbar radiculopathy. For cervical HNP, cervical stenosis and mechanical pain not associated with nerve root involvement, the evidence is anecdotal. The benefits of LOA stem from a combination of factors to include the high volumes administered and the use of hypertonic saline. Hyaluronidase has been shown in most, but not all studies to improve treatment outcomes. Although infrequent, complications are more likely to occur after epidural LOA than after conventional epidural steroid injections.