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Failed Back Surgery Syndrome (F. B. S. S. )의 임상적 분석
오성훈,고용,김영수,문병관,오석전,김광명,김남규 한양대학교 의과대학 1994 한양의대 학술지 Vol.14 No.1
Burton has described the condition about which low back pain and no neurologic improvement was brought after surgical treatment on lumbosacral diseases as Failed Back Surgery Syndrome(FBSS). The author has tried to seek the causative and prognostic factor after consolidating the preoperative clinical symptom, neurologic sign, radiologic finding and LDSPS, covering those patients who had failed to improve or progressed to deteriorate over six months after lumbar laminectomy and discectomy. The results are summarized as follows; The incidence of FBSS following lumbar discectomy was 4.3%. The incidence of FBSS of multiple level disc surgery outnumbered that of single level disc surgery. The Lumbar Disc Surgery Predictive Score(LDSPS) of FBSS group was much lower than that of control group, and this is supposed to be due to faulty patient selection. The preoperative clinical symptoms, such as radicular pain, motor weakness and positive straight leg raising test are much more frequent in control group than in FBSS group and when these clinical features are predominant, we may respect good clinical result. The favorable outcome after treatment of FBSS was achieved in 58.7% and it was hightest in persistent disc herniation. Magnetic Resonance Imaging was the most useful way to take persistent disc herniation from epidural fibrosis. Consequently, the best means to reduce the incidence of FBSS is the precise preoperative diagnosis by using all possible clinical and deliberate radiological imaging modalities(contrast enhanced CT or MRI) and subsequent appropriate patient selection.