• Search Keyword:failed back surgery syndrome

Neurolysis outcome for Failed back surgery syndrome_systemic research review after 2010

  朱辰(Chen Chu);王祈斐(Jeffery Chi-Fei Wang);劉彥青(Yen-Chin Liu)

Failed back surgery syndrome (FBSS) defined as back pain not resolving to a satisfying level or a new back pain after spinal surgery. The scarring and adhesion in epidural space was considered lead to inflammation then this persisted inflammatory process may rise to more adhesion around nerve roots. So this vicious cycle is hard to break even after another surgery. Epidural injection or another surgery may be considered for those who suffered from persisted pain after conservative treatments. Except the above treatments, percutaneous epidural adhesiolysis (PEA) is one of the well-known options nowadays. By using Racz catheter to mechanically lysis adhesion and/or injecting medications such as steroids, saline, local anesthetics or hyaluronidase into epidural space to reduce inflammatory process, PEA can be an effective procedure to relief low back pain with low complication rate. Three randomized controlled trials and 1 observational study were included in this systemic review of PEA in treating low back pain due to FBSS. All of them showed positive results for pain relief and life quality improvement to 6 months after PEA. Besides, the complication rate was low and those complications were mostly self-limited. This review provides good evidence on effectiveness and safety of PEA in dealing with chronic low back pain due to FBSS.


脊椎手術後疼痛症候群(Failed back surgery syndrome)指的是在脊椎手術後疼痛不如預期的緩解,或是再次出現疼痛的問題。

手術後的疤痕及沾黏造成硬脊膜外腔的發炎,而發炎的過程中又會導致更多的沾黏形成,即使是再次進行手術也難以打破這個惡性循環。通常這群病人在接受保守治療後,可以進行硬脊膜外腔的注射或是再次手術,而近來發展出的經皮硬脊膜外腔沾黏解離術(Percutaneous epidural adhesiolysis)可以是另一種選擇。