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Abstract
The Aim Of The Work Of This Study Is To Review The Recent Advances In The Management Of Iumbar Segmental Dysfunction After Back Surgery, Its Causes, Pathogenesis, Clinical Diagnosis, Imaging Studies, How To Avoid And Treament Protocols. Ltunbar segmental dysnmction after back surgery or the failed back surgery syndrome is a clinical condition in which patients who tmdergo one or more surgical procedures for hunbosacral diseases obtain tmsatisfactory longgtenn relief of symptoms with persistent or recurrent low back pain and or leg pam. It is estimated that over 250,000 new laminectomies are perfonned each year in United States. Each year, approximately 30,000-40,000 of laminectomy patients obtain either no relief of symptomatology or a recurrence of symptoms.
Multiple factors that contribute to the failure of ·lumbar surgery to relieve symptoms and effect a favorable outcome from surgery include: incorrect diagnosis, psychological factors, internal disc dismption, missed level or levels, incomplete decompression of the involved nerve roots, retained disc fragment, postoperative discitis and osteomyelitis, epidural abscess, incidental durotomy, herniated intervertebral disc, perineural scarring, postoperative scar tissue, post-decompression spondylolisthesis and pseudoarthrosis of prior fusion.