2012 年 26 巻 2 号 p. 205-210
Objective : To evaluate failed back surgery syndrome (FBSS) in patients with lumbar spinal canal stenosis and degenerative spondylolisthesis, who had undergone posterior decompression without fusion.
Patients and Methods : We evaluated 112 consecutive patients (41 men and 71 women) who underwent posterior decompressive surgery without fusion between April 2001 and March 2010 in the neurosurgical department of Kushiro Rosai Hospital. The average age was 66 years (range, 36-85). The mean follow-up period was 46.3 months (range, 0-108). The definition of FBSS in this study is recurrence of symptoms after recovery of initial symptoms from initial surgery.
Results : Among the 112 patients, 32 (28.6%) suffered from FBSS and 15 (13.4%) underwent re-surgery. In these 15 patients, the causes of FBSS were recurrence of lumbar canal stenosis (n=1), lumbar canal stenosis at upper adjacent level (n=7), lateral recess stenosis (n=1), foraminal stenosis (n=5) and far-out syndrome (n=1). The non-surgical causes of FBSS were sacroiliac joint dysfunction (n=21), piriformis syndrome (n=1), and arteriosclerosis obliterans (n=1).
Conclusion : Accurate diagnosis of the etiology of symptoms is mandatory for appropriate treatment for FBSS. Our result indicated that foraminal stenosis is an important cause of re-surgery, although judgement of surgical indication is difficult. To prevent FBSS, it is important to have a knowledge of various associated diseases such as sacroiliac joint dysfunction.
