Journal of Spine & NeurosurgeryISSN: 2325-9701

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Research Article, J Spine Neurosurg Vol: 5 Issue: 3

Clinical Outcome in Reoperation Following Lumbar Spine Surgery: A Single Surgeon’s Experience of 231 Patients

Elias E1, Nasser Z2, Haddad G1 and Skaf G1*
1Division of Neurosurgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
2Research Center in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
Corresponding author : Ghassan Skaf
Division of Neurosurgery, Department of Surgery, American University of Beirut Medical Center, Riad El Solh, 1107-2020, Beirut, Lebanon
Tel: +9611350000
Fax: +9611363291
E-mail:gskaf@aub.edu.lb
Received: January 19, 2016 Accepted: April 05, 2016 Published: April 10, 2016
Citation: Elias E, Nasser Z, Haddad G, Skaf G (2016) Clinical Outcome in Reoperation Following Lumbar Spine Surgery: A Single Surgeon’s Experience of 231 Patients. J Spine Neurosurg 5:3. doi:10.4172/2325-9701.1000216

Abstract

Objective: Failed back surgery syndrome is a situation of expectation failure after a lumbar spine operation. It is described as continuous or new onset pain post initial surgery; associated with functional disability; affecting daily life activities. Main reasons for FBSS are fibrosis; recurrent disc herniation and spinal instability. Our aim is to identify the proper patient to undergo reoperation as the best treatment modality embodied by the Oswestry Disability Index. Methods: We retrospectively reviewed charts for 231 patients who presented with symptoms and signs of FBSS. Most subjects had at least one previous lumbar surgery at an outside hospital and presented within 3 months period after their last intervention. Radiographs identified the anatomical cause of the patient’s complaints. Post-surgical outcome was assessed using the ODI; by following patients up to 1 year from their latest revision surgery. Results: Successful outcome characterized by more than 50% pain relief (50 percent reduction in mean ODI) was attained at 90 days. Improvement was achieved in 87 % of our population. Mean ODI score was 83.15 pre-operatively and reached 25.38 after our surgical intervention. Moreover; negative correlation between outcome and risk factors were also reported with rate of complications; female gender and elderly age. Conclusion: This study reveals a high success rate of revision spinal surgery. We recommend performing spinal fusion; careful patient selection and proper diagnosis prior to operation. Aiming for precise pathology of failed back surgery syndrome is vital in achieving satisfactory results with redo-operations.

Keywords: Redo surgery; Revision surgery; Spinal fusion; Risk factors;Oswestry Disability Index; Failed back surgery syndrome; Lumbar spine

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