[Profile of the patient with failed back surgery syndrome in the National Institute of Rehabilitation. Comparative analysis]

Abstract

Background: Failed back surgery syndrome is a complication of spine surgery that leads to chronic pain and disability, often with disastrous emotional consequences to the patient.

Aim: To compare the profile of patients whose first surgery was performed in our hospital versus a group that underwent first spine surgery in a different centre.

Methods: Retrospective study with 65 patients; 18 formed group I (first spine surgery performed in our institution), and 47 patients in group II (first surgery performed in another hospital). Background, demographic, clinical features and functional status were compared. In group I the majority of the cases had a previous diagnosis of lumbar stenosis (group I 44.4% vs group II 25.5% p = 0.22), whereas disk herniation was the main diagnosis in group II (group I 22.2% vs group II 61.7% p = 0.001). The main cause of the syndrome in group I was technical error during surgery (61.1%), while in group II this cause represented only 6.3% (p=.001). Among the patients of this latter group, misdiagnosis was highly prevalent (57.4%), against no cases in group I (p=.001). The preoperative functional status between both groups and their recovery in the immediate postoperative period was similar (p = 0.68).

Conclusions: This study suggests that the diagnostic and treatment standards are different between healthcare centres, specifically between academic centres vs. private practice.

Keywords: Cirugía lumbar fallida; Complicaciones; Complications; Failed back surgery syndrome; Low back pain; Lumbalgia; Spine surgery; Síndrome de columna multioperada.