| Failed Back Surgery Syndrome Caused by Failure to Recognize the Compression of the L5 Nerve in the Extraforaminal Zone |
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Jee-Soo Jang, M.D. and Sang-Ho Lee, M.D.1 |
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Department of Neurosurgery, Wooridul Spine Hosptal, Gwangju and Seoul1, Korea |
| 요추 5번 신경의 요천추간 추간공외 압박의 미인식으로 인한 척추 수술 실패 |
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장지수, 이상호1 |
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광주 우리들병원 신경외과, 우리들병원 신경외과1 |
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| Abstract |
Objective
This study is a retrospective clinical analysis of failed back surgery syndrome that is due to failure to recognize the compression of the L5 nerve in the extraforaminal zone.
Methods
Ten patients had undergone previous spinal surgery due to the L5 radiculopathy, however, their pain was not relieved after surgery. Their failed back surgery syndrome resulted from the failure to recognize the L5 nerve entrapment in the extraforaminal zone. All the patients underwent further surgical decompressions through the paramedian tangential approach.
Results
Pain relief was obtained in all patients immediately after surgery. The mean follow-up period was 13 months (range, 5-20 months). Pain was measured by the Numerical Rating Scale(NRS), function was assessed by Oswestry Disability Index (ODI) scores, and patient satisfaction was measured by the North American Spine Society Outcome Questionnaire. The mean NRS improved from 7.6 before the surgery to 2.2 after the surgery(p<0.001). The mean ODI was 68 before surgery and 24 after surgery. All patients were satisfied with their result at the last follow-up.
Conclusion
Extraforaminal entrapment of the L5 nerve in the lumbosacral spine is an important entity to identify in those patients with L5 radiculopathy for avoiding failed back surgery syndrome.
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| Keywords:
Failed back surgery syndrome․Extraforaminal entrapment․Lumbosacral spine․Paramedian tangential approach |
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