Failed back surgery pain syndrome: therapeutic approach descriptive study in 56 patients

Rev Assoc Med Bras (1992). May-Jun 2011;57(3):282-7.
[Article in English, Portuguese]

Abstract

Objective: The authors show the clinical evaluation and follow-up results in 56 patients diagnosed with a failed back surgery pain syndrome.

Methods: Descriptive and prospective study conducted over a one-year period. In this study, 56 patients with a failed back surgery pain syndrome were assessed in our facility. The age ranged from 28 to 76 years (mean, 48.8 ± 13.9 years). The pain was assessed through a Visual Analog Scale (VAS).

Results: Postoperative pain was more severe (mean VAS score 8.3) than preoperative pain (7.2). Myofascial pain syndromes (MPS) were diagnosed in 85.7% of patients; neuropathic abnormalities associated or not with MPS were found in 73.3%. Drug therapy associated with physical medicine treatment provided > 50% pain improvement in 57.2% of cases; trigger point injection in 60.1%, and epidural infusion of morphine with lidocaína in 69.3% of refractory cases.

Conclusion: In patients with a post-laminectomy syndrome, postoperative pain was more severe than preoperative pain from a herniated disk. A miofascial component was found in most patients.

MeSH terms

  • Adult
  • Aged
  • Analgesics, Opioid / therapeutic use
  • Anesthetics, Local / therapeutic use
  • Failed Back Surgery Syndrome / physiopathology
  • Failed Back Surgery Syndrome / therapy*
  • Female
  • Humans
  • Lidocaine / therapeutic use
  • Male
  • Middle Aged
  • Morphine / therapeutic use
  • Myofascial Pain Syndromes / physiopathology
  • Myofascial Pain Syndromes / therapy*
  • Pain Measurement
  • Pain, Postoperative / physiopathology
  • Pain, Postoperative / therapy*
  • Prospective Studies

Substances

  • Analgesics, Opioid
  • Anesthetics, Local
  • Morphine
  • Lidocaine