title: Failed back surgery syndrome: casuistic and etiology.
abstract: OBJECTIVE
  To report our data of cases of failed back surgery syndrome (FBSS) and surgical and nonsurgical etiologies.
  
  
  METHODS
  The medical charts of 121 patients submitted to laminectomy, hemilaminectomy combined with discectomy and/or foraminotomy between January 1997 and October 2004 in the Instituto of Neurologia Deolindo Couto were reviewed. The inclusion criterion was does not improve or the symptoms return after the surgery and with a minimum of three medical consultations with adequate investigation for the diagnosis. The patients had been divided in three main pre-surgical diagnosis: herniated disc, lumbar stenosis and the association of these.
  
  
  RESULTS
  From the 121 patients submitted to spine surgical intervention, 47 (38.8%) had presented criteria for the FBSS. Among the 26 patients who had presented operative diagnosis of lumbar stenosis, 8 (30.7%) had presented FBSS; of the 83 with disc herniation, 31 (37.3%) had the syndrome; and the 12 patients with lumbar stenosis associated with disc herniation, 7 (58.3%) had failure of the back surgery.
  
  
  CONCLUSIONS
  The failure of back surgery remains a challenge for the surgeons. There is an incessant search for the causes and the action mechanisms of this syndrome and the best method of treatment.
authors.affiliation: Instituto de Neurologia Deolindo Couto, Serviço de Neurocirurgia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rua Buarque de Macedo 14/606, 22220-030 Rio de Janeiro RJ, Brazil.
authors.forename: Flávio Freinkel
authors.initials: FF
authors.lastname: Rodrigues
authors.forename: Diego Cassol
authors.initials: DC
authors.lastname: Dozza
authors.forename: Claudio Russio
authors.initials: CR
authors.lastname: de Oliveira
authors.forename: Ricardo Gomes
authors.initials: RG
authors.lastname: de Castro
mesh_terms: D000328:Adult; D000368:Aged; D001416:Back Pain / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D007796:Laminectomy / Q000009:adverse effects*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013130:Spinal Stenosis / Q000601:surgery*; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure