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首页> 外文期刊>Advances and technical standards in neurosurgery >Minimally invasive procedures for the treatment of failed back surgery syndrome.
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Minimally invasive procedures for the treatment of failed back surgery syndrome.

机译：微创手术治疗失败的背部手术综合征。

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摘要

Failed back surgery syndrome has become unfortunately a common clinical entity. FBSS does not have one specific treatment because it does not have one specific cause. Some features are shared with chronic low back pain (CLBP) and some pathological processes are specific. Both pathologies are leading causes of disability in the industrialized world and costly medical and surgical treatments are continuously used despite their limited efficacy. Nonetheless, evidence based practice guidelines are systematically developed. In this chapter we cautiously review the vast, complex and at times contradictory literature regarding the treatment of FBSS. Interventional Pain literature suggests that there is moderate evidence (small randomized or non randomized or single group or matched case controlled studies) for medial branch neurotomy and limited evidence (non experimental one or more center studies) for intra-discal treatments in mechanical low back pain. There is moderate evidence for the use of transforaminal epidural steroid injections, lumbar percutaneous adhesiolysis and spinal endoscopy for painful lumbar radiculopathy and spinal cord stimulation and intrathecal pumps mostly after spinal surgery. In reality there is no gold standard for the treatment of FBSS but, these results seem promising.
机译：不幸的是，失败的背部手术综合征已成为常见的临床实体。 FBSS没有一种特定的治疗方法，因为它没有一种特定的原因。慢性下腰痛（CLBP）具有某些特征，某些病理过程是特定的。两种病理都是导致工业化世界中残疾的主要原因，尽管疗效有限，但仍继续使用昂贵的医学和外科治疗方法。尽管如此，系统地制定了循证实践指南。在本章中，我们谨慎地回顾了有关FBSS治疗的大量，复杂且有时相互矛盾的文献。介入性疼痛文献提示，对于机械性下背痛，有中等证据（小随机，非随机或单组或匹配的病例对照研究）用于内侧支神经切开术，而针对椎间盘内治疗的证据有限（非实验性一项或多项中心研究）。 。有中等程度的证据表明，经椎间孔硬膜外注射类固醇，腰椎经皮粘连溶解术和脊柱内窥镜检查主要用于脊柱外科手术后的疼痛性腰神经根病变和脊髓刺激以及鞘内泵。实际上，目前尚无用于治疗FBSS的金标准，但这些结果似乎很有希望。

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