Pain perception and emotional impact in patients with failed back surgery syndrome
Keywords:
Chronic pain, failed back surgery syndrome, psycho-social impact, quality of lifeAbstract
Introduction: The literature provides very limited guidance on the comprehensive management of patients suffering from surgical failure syndrome. Despite its debilitating effect and relative prevalence among the population undergoing spinal surgery, there are few studies investigating its impact on daily life.
Methodology: This is a cross-sectional, comparative analytical study, with a sample of a test group (I), diagnosed with surgical failure syndrome (n=16) and a control group (II) submitted to consultation at the Pain Clinic (n=15). The instruments were the visual analog scale and Fischer's soreness. To assess quality of life, the WHOQOL-Bref questionnaire was used and, for the emotional factors anxiety and depression, the Beck Anxiety and Depression Inventory was used.
Results: In the sample of both groups there was a predominance of females, mean age of 42.3±5.8 years (group I), most married and mean schooling of 8.4±3.0 years. Mean pain time was 0.7±0.3 months after surgery in group I with the lowest pain threshold. The physical dimensions and social relationships were the most compromised in quality of life, as well as levels of anxiety and depression.
Conclusion: These results showed greater pain intensity, worse quality of life, anxiety and depression in group I, suggesting greater knowledge of possible postoperative complications, seeking not to allow an abnormal pattern of functionality to be established.
References
Hussain A, Erdeck M. Interventional Pain Management for Failed Back Surgery Syndrome. Pain Pratice 2013.14(1):64−78
Kulkarni KR, Talakanti SK. Management off failed back surgery syndrome with transforaminal epidural steroidand epidural saline adhesiolysis. Indian J Pain. 2014;28(2):117-20.
Shamim MS, Parekh MA, Bari ME, Enam SA, Khursheed F. Microdiscectomia para hérnia de disco lombossacral e frequência de cirurgia de disco com falha. Neurocirurgia Mundial. 2010; 74 :611-6.
Parker SL, Mendenhall SK, Godil SS, et al. Incidence of low back pain after lumbar discectomy for herniated disc and its effect on patient-reported outcomes. Clin Orthop Relat Res. 2015; 473:1988–99.
Hong X, Liu L, Bao J, Shi R, Fan Y, Wu X. Characterization and risk fator analysis for reoperation after microendoscopic diskectomy. Orthopedics. 2015;38:e490–6
Rothenfluh DA, Mueller DA, Rothenfluh E, Min K. Pelvic incidence of lumbar lordoses mismatch predisposes to adjacente segment disease after lumbarspinal fusion. EurSpine J. 2015; 24:1251–8.
Yamada H, Terada M, Iwasaki H, et al. Improved accuracy of diagnosis of lumbar intra and/or extra foraminal stenosis by use of three-dimensional MR imaging: comparison with conventional MR imaging. J Orthop Sci. 2015; 20:287–94.
Manca A, Eldabe S, Buchser E, Kumar K, Taylor RS. Relationship between health related quality of life, pain, and functional disability in neuropathic pain patients with failed back surgery syndrome. Value Health. 2010;13(1):95-102.
Hoppenfeld S. Propedêutica ortopédica: coluna e extremidades. São Paulo: Atheneu; 1998.
HelfensteIn Junior M, Goldenfum MA, Siena C. [Occupational low back pain]. Rev Assoc Med Bras. 2010;56(5):583-9.
Fischer AA. Muscle pain syndromes and fibromyalgia. Musculoesk J Pain. 1998;6(1):107-1.
Pimenta CAM. Escalas de avaliação de dor. In: Teixeira MD, (editor). Dor conceitos gerais. São Paulo: Limay; 1994. 46-56p.
Fleck MP, Louzada S, Xavier M, Chachamovich E, Vieira G, Santos L, et al. [Aplication of the Portuguese version of the abbreviated instrument of quality life WHO-QOL- -brev]. RevSaude Publica. 2000;34(2):178-83.
Leyfer OT, Ruberg JL, Woodruff-Borden J. Examination of the utility of the Beck Anxiety Inventory and its factors as a screener for anxiety disorders. J AnxietyDisord. 2006;20(4):444-58.
Gorenstein C, Andrade L. Validation of a Portuguese version of the Beck Depression Inventory and the State-Trait Anxiety Inventory in Brazilian subjects. Braz J Med Biol Res. 1996;29(4):453-7.
Nachemson AL. Evaluation of results in lumbar spine surgery. Acta Orthop Scand Suppl. 1993; 251:130–3.
North RB, Campbell JN, James CS, et al. Failed back surgery syndrome: 5-year follow-up in 102 patients undergoing repeated operation. Neurosurgery. 1991; 28:685–90.
Waddell G, McCulloch JA, Kummel E, Venner RM. Non organic physical signs in low-backpain. Spine (PhilaPa 1976) 1980; 5:117–25.
Provenzano DA. Diagnostic discography: what is the clinical utility? Curr Pain Headache Rep. 2012; 16: 26– 34.
Menefee LA, Frank ED, Doghramji K, Picarello K, Park JJ, Jalali S, et al. Self-reported sleep quality and quality of life for individuals with chronic pain conditions. Clin J Pain. 2000;16(4):290-7.
Atkinson JH, Slater MA, Capparelli EV, et al. A randomized controlled trial of gabapentin for chronic low back pain with and without a radicular component. Pain. 2016; 157:1499–507.
