الفهرس 
Anatomy and Biomechanics of Lumbo Sacral SpineOnly 14 pages are availabe for public view
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Abstract
Failed back surgery syndrome (FBSS) or its euphemism ”failed , back syndrome” is persistent or recurrent low back pain with or Without sciatica, following one or more lumbar spine operations. In a broader sense, it reflects the failure of lumbar spine surgery to relieve pain and incapacitation. According to a statistical study published in 1981, the primary organic factors leading to FBSS (excluding spondylolisthesis) are lateral spinal stenosis (57-58%), central stenosis, including fusion overgrowth (7-14%), adhesive arachnoiditis (6-16%); recurrent or persistent disc herniation (12-16%);epidural fibrosis (6-8%); nerve injury during surgery (less than 5%); chronic mechanical pain (less then 5%); transitional syndrome, above fusion, (less than 5%); surgery performed , at wrong level or wrong side (less than 5%); and unknown (less than 5%). Clinical evaluation of FBSS patients requires full history taking, psychological assessment and thorough physical and neurologic examination. These are particularly helpful in the differential diagnosis of specific clinical syndromes. As a simple screen for inflammatory autoimmune diseases every patients with FBSS deserves an eythrocyte sedimentation rate, if not more extensive rheumatologic screening. Lateral flexion-extension X-ray views are the key to the diagnosis of segmental instability, Myelography is definitive for the diagnosis of , arachnoiditis. C.T. scan offers more information about the postoperative lumbar spine particularly in the differeniation between recurent herniated disc and postoperative scarring. : MR1 is the recent and more benefit.