title: Failed back surgery pain syndrome: therapeutic approach descriptive study in 56 patients.
abstract: OBJECTIVE
  The authors show the clinical evaluation and follow-up results in 56 patients diagnosed with a failed back surgery pain syndrome.
  
  
  METHODS
  Descriptive and prospective study conducted over a one-year period. In this study, 56 patients with a failed back surgery pain syndrome were assessed in our facility. The age ranged from 28 to 76 years (mean, 48.8 ± 13.9 years). The pain was assessed through a Visual Analog Scale (VAS).
  
  
  RESULTS
  Postoperative pain was more severe (mean VAS score 8.3) than preoperative pain (7.2). Myofascial pain syndromes (MPS) were diagnosed in 85.7% of patients; neuropathic abnormalities associated or not with MPS were found in 73.3%. Drug therapy associated with physical medicine treatment provided > 50% pain improvement in 57.2% of cases; trigger point injection in 60.1%, and epidural infusion of morphine with lidocaína in 69.3% of refractory cases.
  
  
  CONCLUSIONS
  In patients with a post-laminectomy syndrome, postoperative pain was more severe than preoperative pain from a herniated disk. A miofascial component was found in most patients.
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Manoel Jacobsen
authors.initials: MJ
authors.lastname: Teixeira
authors.forename: Lin Tchia
authors.initials: LT
authors.lastname: Yeng
authors.forename: Oliver Garcia
authors.initials: OG
authors.lastname: Garcia
authors.forename: Erich Talamoni
authors.initials: ET
authors.lastname: Fonoff
authors.forename: Wellingson Silva
authors.initials: WS
authors.lastname: Paiva
authors.forename: Joaci O
authors.initials: JO
authors.lastname: Araujo
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use; D055111:Failed Back Surgery Syndrome / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D009209:Myofascial Pain Syndromes / Q000503:physiopathology / Q000628:therapy*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology / Q000628:therapy*; D011446:Prospective Studies
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D008012:Lidocaine