Causes and prevention of failed back surgery syndrome after microdiscectomy

A herniated disc is the most common cause of leg pain among the adult population. Surgery is one of the treatment methods for this condition. Materials. The results of surgical treatment of 593 patients with symptomatic lumbar hernia and their postoperative observation for 3 years have been studied. The mean age was 43.4 ± 7.8 years (63 % men, 37 % women). 619 microdiscectomy (MLD) surgery operations have been conducted. Also the technology of new regime of postoperative locomotion was invented and explained to all patients. Results. 94.7 % of patients were satisfied with the results of surgical treatment during the observation period. The failed back surgery syndrome (FBSS) was diagnosed in 33 (5.6 %) patients and 26 (4.4 %) were re-operated. Such FBSS causes as: scar-commissural changes in 38.5 % of cases and recurrent disc herniation in 61.5 % of patients were identified during reoperation. Also the association between the operating surgeon experience and the FBSS number after intervention has been found. Experienced surgeon (20 years and more) had – 2.7 % of FBSS cases, while surgeons with experience of 10 to 20 years had – 4.7 % and young surgeons (less than 10 years) had – 7.5 % of FBSS. In the group of 147 (24.8 %) patients who strictly followed new regime of postoperative locomotion, FBSS developed in 3 (2 %) patients, all of them underwent reoperation. In another group of 446 (75.2 %) patients who failed to comply with the postoperative locomotion, FBSS occurred in 30 (6.7 %) cases, and 23 (5.2 %) of them were re-operated. Conclusion. MLD is an effective surgery bringing relief to patients both immediately after surgery and in the long term. The MLD results depend on the surgeon experience and patient compliance with new regime of postoperative locomotion.

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Nekrasov A.D. – neurologist, candidate of medical sciences, e-mail: doctornek@gmail.com