Rheumatology: Current Research

Rheumatology: Current Research
Open Access

ISSN: 2161-1149 (Printed)

+44-20-4587-4809

MISS; is an option for the treatment of failed back surgery syndrome


International Conference and Exhibition on Orthopedics & Rheumatology

August 13-15, 2012 Hilton Chicago/Northbrook, USA

Tolgay Satana Murat Erguven, Ali Fincan and Kamil Barlas

Accepted Abstracts: Rheumatology & Orthopedics

Abstract :

FailedBackSpineSurgery (FBSS) is one of the difficult defined pain syndrome. Usually origine of pain is unknown post spinalsurgery. Pain source is unclear, and never terminaldiagnosis. Clinicalapperance is mostly complicated with caudaequina, reherniation, battered root, epidural fibrosis, arachnoiditis, intervertebral instability or spinal stenosiseither at the previous surgical site or at adjacent levels. The Definition of FBSS is simplythat is tocreate a paingenerator on spine by surgical way.FBSS and Chronic low back pain have completely different pain pattern. FBSS; related with surgery, unsufficient surgical treatment, over treatment, malpractice.It refers to a condition in which a patient has undergone back surgery with a poor outcome. Etiology: Poor selection for surgery and the patient has had a psychological profile orpathophysiology, improper selection and misdiagnosis, inadequate preoperative evaluation and diagnosticwork-up, improper or inadequate surgery. Objectives: Evaluate responsible reason of FBSS mechanical and neurologic compromise and to find pain generators and prospect of eliminating the pain and to improvefunction Patients and Method:18 patients were included prospective study, 14 females 4 males, Main age 55, Followup 6 m ( range 3-24 months)10 patients are treated single missway, 8 patients combined with open surgery. Methods: In ten cases, there was a single missprocedure, such as percutaneous for aminoplasty and/orepidusocopy performed (all of them postdiscectomys) in 8 additional cases, two surgical procedure have been performed, 2 patient remove hardware and limited decompression without fusion and if it is necessary combined with epiduroscopy, 2 patient have fusion surgery because of recurrent spondilolysthesis after one level discectomy, 4 patient had extremely spinalstenosis, and hardware occupition c-spinalechanel, excesive decompression and posterior shortfusion. Key Surgery consists of different stages; remove if there is hardware ASAP, debridement, and minimal decompression. Results: Previous studies have used a measure of successful outcome â�?¥ 50% of original pain relief as a successful outcome. The first VAS and Questioneire score had been taken respectively high before surgery. These two scores (pre and post) were then used to provide absolute difference more than 50 percent. Conclusion: MISS is an option which is significantly reduced pain in almost all patients. Pain relief was significantly and highly correlated with reduced analgesic intake and patient satisfaction. MISS should be considered as a potential treatment option for FBSS.MISS is not palliativetreatment in which terminal stage of allotheroptions. Our results suggest that although all ages have the potential to benefit from MISS andinterventonalteqniques.

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