Abstract
Perceived knowledge suggests that patients with Failed Back Surgery and a poor psychological profile would respond poorly to surgical interventions. This comparative study was designed to identify if there was a significant difference in the outcome following endoscopic spinal intervention in patients with Failed Back Surgery when compared to those who had no previous interventions.
Between April 1997 and November 1998, 54 patients with failed open back surgery and 85 without previous interventions were included in the study, underwent aware state pain source identification and endoscopic foraminal interventions. Pre- and post-operative assessment at 2 years was made using the Distress and Risk Assessment Method (DRAM), Oswestry Disability Index (ODI) and a Visual Analogue Pain Scale (VAPS). A Mann-Whitney U and Wilcoxon-Signed Rank tests were performed.
Patients with failed back surgery demonstrated greater psychological distress, disability (p < 0.05) and pain pre-operatively than those who underwent primary endoscopic interventions. Post-operatively both groups demonstrated significant improvement and no difference was found in the Zung, DRAM, ODI and VAPS scores.
With aware state pain source identification, targeted minimal intervention and discrete tissue ablation patients with failed back surgery with associated depression can demonstrate favourable physical and psychometric outcomes.
The abstracts were prepared by Dr C Pither. Correspondence should be addressed to him at the British Orthopaedic Association, Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PN
