Ayşegül CEYLAN, Güngör Enver ÖZGENCİL, İbrahim AŞIK, Burak ERKEN

Evaluation of the efficacy of epiduroscopic adhesiolysis in failed back surgery syndrome

Background/aim: We aimed to compare the results of the treatment of the patients with failed back surgery syndrome (FBSS) bymechanical lysis and steroid hylase injection via epiduroscopy due to their stabilization status and to detect the effect of pathologicaldiagnostic markers on prognosis and ongoing treatment protocol.Materials and methods: Eighty-two patients with FBSS symptoms were included. Two groups were composed as group I (stabilized)and group II (nonstabilized). All patients were evaluated using the oswestry disability index (ODI) and visual analogue scale (VAS)scores before and after treatment at 1, 3, 6, and 12 months and using the patient satisfaction scale at 12 months following treatment.Epidural scar tissue visual and mechanical signs were also recorded.Results: Mean VAS scores were 7.8 and 3.28 points in group I (P < 0.001) and 7.51 and 2.74 points in group II (P < 0.001) at thebeginning and at 12 months, respectively. Mean ODI scores were 34.05 and 22.16 points in group I (P < 0.001) and 30.74 and 19.46points in group II (P < 0.001) at the beginning and at 12 months. VAS and ODI scores decreased significantly in both groups, but weremore significant in the nonstabilized group (P < 0.001). Moderate or severe fibrous tissue was observed in 86.58% of the patients andpatient satisfaction scores were very good or good in 78.06% of the patients. During the procedure, a dura rupture developed in fourpatients in the stabilization group and in two patients in the nonstabilization group; however, none of these patients developed a spinalheadache and no significant permanent complication arose.Conclusion: We suggest that epidural adhesiolysis, hyaluronidase, and steroid injection in patients with FBSS chronic low back painand/or radicular symptoms may give reliable information about the quality of life, accuracy of diagnosis, and the possible course of thepresent findings and may be more effective in nonstabilized patients.

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