Analysis of causes of failed back surgery syndrome and the possibility of revision surgery

Objective To investigate the causes and reoperative effect of failed back surgery syndrome(FBSS). Methods 24 patients with failed back surgery syndrome were treated surgically. The primary surgeries were fenestration laminotomy and discectomy (10 cases); total or hemi-laminectomy and discectomy(14 cases), among whom 3 cases were undergone transpedicle screw fixation .The revision procedure included hemilaminectomy or total laminectomy, discectomy, enlarged decompression of nerve root canal, internal fixation, and posteriolateral or intervertebral fusion. Results The major causes of FBSS included recurrent disc herniation,secondary stenosis,wrong positioning of the operative level, failure of internal fixation. All patients with secondary operation were followed up from 2 months to 3 years and obtained satisfactory outcomes. The clinical improvement rate was 80.2%, and the results were excellent in 18 cases, and good in 6 cases. Conclusions Satisfactory outcome can be gained if the secondary operation is chose properly for FBSS.