Revista da Associação Médica Brasileira
Print version ISSN 0104-4230
TEIXEIRA, Manoel Jacobsen et al. Failed back surgery pain syndrome: therapeutic approach descriptive study in 56 patients. Rev. Assoc. Med. Bras. [online]. 2011, vol.57, n.3, pp. 286-291. ISSN 0104-4230. http://dx.doi.org/10.1590/S0104-42302011000300010.
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.
Keywords : Low back pain; intervertebral disk displacement; post-laminectomy syndrome.