IPSILATERAL RADICULAR PAIN FOLLOWING DISCECTOMY

1. IPSILATERAL RADICULAR PAIN FOLLOWING DISCECTOMY K. Liaropoulos, P. Spyropoulou, P. Korovesis, Th. Maraziotis, N. Papadakis

2. FAILED BACK SURGERY SYNDROME(FBSS) Refers to surgeries in the lumbar region of the spine for varying reasons (such as a herniated disc or spinal stenosis) and of various surgical techniques, without satisfactory improvement of symptoms. The etiology is multifactorial Its frequency reaches 10-40%

3. The development of a herniated disc at the same or another level of the same side and the consequent radicular syndrome, is in our opinion, a new nosological entity and the previous intervention should not be considered "failed", even if it relates indirectly, probably for reasons of biomechanical dynamics to the foregoing procedure.

4. The term "failed back surgery syndrome" is the subject of this study, refers to cases of FBSS where re-operation was necessary due to persistence (or deterioration) or recurrence of the same radicular syndrome with the syndrome of the preoperative period of the first intervention which was performed by the same technique (open hemilaminectomy discectomy).It is part of the general FBSS with more specific and strict selection criteria.

5. OBJECT This study aims to: 1) investigate the etiology of the persistence or recurrence of the same radicular syndrome (the same root in the same side) in cases where re-operation was necessary. 2) investigate the relationship of gender, age and profession with persistence or recurrence of radicular pain. 3) investigate the correlation of time of occurrence of radicular pain

6. MATERIAL AND METHOD PERIOD: February. 1995 - January 2000 MATERIAL: 64 patients showed either persistence or recurrence of pre-operative symptoms During the same period 1016 patients had undergone surgery for a lumbar herniated disc They were studied in terms of: medical history objective neurological examination imaging methods surgical findings postoperative findings

7. LOW BACK PAIN Common symptom (second in frequency after headache) 5% annual rate. Cause of activity limitation to adults under 45 years of age. Cause of loss of earnings and workers' compensation in the USA 14 billion US dollars annual cost for diagnosis and treatment. 1% accompanied by ischialgia, which in majority is due to a herniated intervertebral disc

8. ISCHIALGIA - LUMBAR HERNIATED DISC 85% of patients have a favorable result following conservative treatment, in average 6 weeks (rest, analgesics, physiotherapy) 15% of patients require surgical intervention In 8% -25% of cases, surgical treatment fails to relieve patients from pain or recurrence of symptoms after different than other times interval.

9. Table 1: Epidemiological characteristics of studiedcases

10. Table 2: Age-focused analysis of cases

11. Table 3: Comparison of surgical findings and CTin 32 cases

12. Table 4: Comparison of surgical findings and MRIin 46 cases

13. Table 5: Postoperative monitoring andepidemiological characteristics

14. Table 6: The clinical profile of 64 patients

15. Table 7: Surgical findings and results

16. Table 8: Time of recurrence of symptoms and results