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01-11-2008 | Clinical Article

Outcome following lumbar disc surgery: the role of fibrosis

Authors: Daniel Benzecry Almeida, Mirto Nelson Prandini, Yumi Awamura, Maria Luiza Vitola, Monica Pedro Simião, Jeronimo Buzetti Milano, Kelly Cristina Bordignon, Mariane Pastuch Ache, Ricardo Ramina

Published in: Acta Neurochirurgica | Issue 11/2008

Abstract

Background

Failed-back surgery syndrome remains a challenge for spinal surgeons. It can be related to several causes, including poor surgical indication, misdiagnosis, surgical technique failure, spondilodiscitis and fibrosis. Fibrosis has been associated with a poorer outcome in lumbar disc surgery, although its role in the generation of symptoms is not yet clear. In this study, the authors have analyzed any possible correlation between the clinical outcome and the degree of fibrosis.

Method

Forty consecutive patients were enrolled in a prospective study. All of them had operations in the lower lumbar disc in a single level for the first time. Three months after the operation they were submitted to clinical outcome evaluations and questionnaires, including Numeric Pain Rating scales (NPR) for lumbar and leg pain, the McGill Pain Questionnaire, The Quebec Back Pain Disability scale (QBPD) and Straight Leg Raising test. These data were correlated with the degree of fibrosis as revealed by Magnetic Resonance Imaging (MRI).

Findings

After 3 months, the NPR values for lumbar and leg pain ranged from 0 to 8 (mean 2.32 and 1.67 respectively). The values of the post-operative QBPD scale ranged from 1 to 71 (mean 25.9). Every patient showed a varied degree of fibrosis on MRI. However, statistical analysis depicted no significant correlation between fibrosis and a poorer clinical outcome for pain and disability.

Conclusions

The authors found no correlation between excessive fibrosis with lumbar and leg pain, disability or straight leg resistance. The role of fibrosis in the generation of symptoms in patients who have had lumbar disc surgery should be reevaluated.

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Title: Outcome following lumbar disc surgery: the role of fibrosis
Authors: Daniel Benzecry Almeida
Mirto Nelson Prandini
Yumi Awamura
Maria Luiza Vitola
Monica Pedro Simião
Jeronimo Buzetti Milano
Kelly Cristina Bordignon
Mariane Pastuch Ache
Ricardo Ramina
Publication date: 01-11-2008
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 11/2008
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-008-0131-2

At a glance: The STEP trials

Springer Medicine

Outcome following lumbar disc surgery: the role of fibrosis

Abstract

Background

Method

Findings

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Method

Findings

Conclusions

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