Managing chronic pain of spinal origin after lumbar surgery: The role of decompressive surgery

Frank M. Phillips*, Benjamin Cunningham, F. Todd Wetzel, Joshua Prager, Joel Saal, Paul Slosar, Barry Straus, Dennis Turk, Gunnar B.J. Andersson, James Weinstein

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

Study Design. A literature review was conducted. Objective. To provide an evidence-based approach for patients with neurogenic symptoms after lumbar surgery. Summary of Background Data. Patients may present with chronic pain of spinal origin after lumbar surgery. Failure to decompress the involved neural structures adequately or progression of the underlying degenerative condition may lead to neurologic symptoms. Methods. A literature search of peer-reviewed publications that investigate etiologies and treatments for neurogenic pain in patients who have undergone previous spinal surgery was conducted. Results. In the absence of profound or progressive neurologic deficits, most patients with chronic back and leg pain who have undergone previous spinal surgery should be treated nonoperatively. Additional decompressive surgical intervention may be justified in patients with well-defined, discrete pathology amenable to surgical correction who have been refractory to conservative care. The surgery typically will include meticulous decompression of the affected neural structures and may include arthrodesis to address any deformity or instability. Conclusions. In a patient presenting with neurogenic symptoms after lumbar surgery, a meticulous workup is required to elucidate the source of these symptoms. Surgical indications are similar to those for primary lumbar spinal surgery and include a well-defined anatomic source of neural compression that is amenable to a surgical solution.

Original languageEnglish (US)
Pages (from-to)2547-2554
Number of pages8
JournalSpine
Volume27
Issue number22
DOIs
StatePublished - Nov 15 2002

Keywords

  • Claudication
  • Decompression
  • Failed lumbar surgery reoperation

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

Fingerprint Dive into the research topics of 'Managing chronic pain of spinal origin after lumbar surgery: The role of decompressive surgery'. Together they form a unique fingerprint.

Cite this