CHALLENGING MANAGEMENT OF FAIL BACK SURGERY SYNDROME IN A 66-YEAR-OLD FEMALE : A CASE REPORT OF PERSISTENT PAIN AFTER MULTIPLE LUMBAR SURGERIES
DOI:
https://doi.org/10.31004/jkt.v5i4.34970Keywords:
Fail Back Surgery Syndrome, Lumbar spine surgery, Canal stenosis, Spondylolisthesis, Spinal cord stimulationAbstract
Laporan kasus ini menggambarkan seorang pasien wanita berusia 66 tahun yang didiagnosis menderita Fail Back Surgery Syndrome (FBSS) setelah dua kali operasi tulang belakang lumbal. Pasien awalnya mengalami nyeri punggung bawah kronis yang menjalar ke kedua kaki, yang menetap meskipun telah dilakukan intervensi bedah. Pencitraan resonansi magnetik (MRI) pra-bedah menunjukkan stenosis kanal pada L3-4 dan L5-S1, dengan spondylolisthesis pada L4-5. Operasi pertama melibatkan dekompresi saluran akar dan penempatan sangkar lumbal pada L4-5 dan L5-S1, diikuti dengan operasi kedua yang terdiri dari laminektomi dan fiksasi internal lumbal posterior dengan batang dan sekrup. Meskipun telah dilakukan prosedur ini, pasien terus mengalami rasa sakit yang parah dan berkurangnya mobilitas. Gejala pasca operasi yang sedang berlangsung menghadirkan tantangan dalam menangani kasus ini, terutama mengingat usia pasien dan penyebab utama FBSS. Penilaian neurologis menunjukkan berkurangnya refleks dan defisit sensorik, yang mengindikasikan kompresi akar saraf. Evaluasi diagnostik mengesampingkan kegagalan perangkat keras dan kompresi sisa, sehingga mengkonfirmasikan diagnosis FBSS. Pengelolaan FBSS masih merupakan tantangan dan memerlukan pendekatan yang disesuaikan. Kasus ini menekankan pentingnya perencanaan pra-bedah individual, pemantauan ketat pasca operasi, dan menggabungkan berbagai pilihan pengobatan. Intervensi di masa depan, seperti stimulasi sumsum tulang belakang, dapat memberikan bantuan, menyoroti perlunya penelitian berkelanjutan untuk meningkatkan hasil pada pasien FBSS.References
Ashraf, A. (2021). Long Term Effects on Quality of Life After Short Segment Pedicle Screw Fixation of Thoracolumbar Fractures in Pakistani Population. Orthopedics and Sports Medicine Open Access Journal. https://doi.org/10.32474/osmoaj.2021.05.000220
Berger, A. A., Urits, I., Hasoon, J., Gill, J., Aner, M., Yazdi, C., Viswanath, O., Cornett, E. M., Kaye, A. D., Imani, F., Varrassi, G., & Simopoulos, T. (2021). Improved Pain Control With Combination Spinal Cord Stimulator Therapy Utilizing Sub-Perception and Traditional Paresthesia Based Waveforms: A Pilot Study. Anesthesiology and Pain Medicine. https://doi.org/10.5812/aapm.113089
Cipollina, G. (2024). Long?term Impact of Spinal Cord Stimulation in FBSS Patients: A Retrospective Ten?year Analysis. Pain Practice. https://doi.org/10.1111/papr.13343
Edinoff, A. N., Kaufman, S. E., Alpaugh, E. S., Lawson, J., Apgar, T. L., Imani, F., Khademi, S.-H., Cornett, E. M., & Kaye, A. D. (2022). Burst Spinal Cord Stimulation in the Management of Chronic Pain: Current Perspectives. Anesthesiology and Pain Medicine. https://doi.org/10.5812/aapm-126416
Funao, H., Yokosuka, K., Ukai, J., Nakanishi, K., Paku, M., Tomita, T., Hoshino, M., Saito, T., Ishii, K., & Sato, K. (2022). Efficacy of Minimally Invasive Trans-Sacral Canal Plasty Between Patients With and Without Failed Back Surgery Syndrome. Medicina. https://doi.org/10.3390/medicina58020251
Giordan, E., Billeci, D., Verme, J. Del, Varrassi, G., & Coluzzi, F. (2021). Endoscopic Transforaminal Lumbar Foraminotomy: A Systematic Review and Meta-Analysis. Pain and Therapy. https://doi.org/10.1007/s40122-021-00309-1
Goudman, L., Smedt, A. De, Louis, F., Stalmans, V., Linderoth, B., Rigoard, P., & Moens, M. (2022). The Link Between Spinal Cord Stimulation and the Parasympathetic Nervous System in Patients With Failed Back Surgery Syndrome. Neuromodulation Technology at the Neural Interface. https://doi.org/10.1111/ner.13400
Harman, F., Aydin, S., Sencan, S., Akdeniz, E., Guvenc, Y., Saracoglu, A., Eyigör, C., Uyar, M., & Gunduz, O. H. (2020). Percutaneous Spinal Cord Stimulation for Failed Back Surgery Syndrome: A Retrospective Study. Turkish Neurosurgery. https://doi.org/10.5137/1019-5149.jtn.30598-20.2
Hasoon, J., Berger, A. A., & Urits, I. (2020). Treatment Options for Patients Suffering From Failed Back Surgery Syndrome. Anaesthesiology Intensive Therapy. https://doi.org/10.5114/ait.2020.101043
Higashiyama, N., Tamura, S., & Sugawara, T. (2023). Efficacy of Spinal Cord Stimulation for Failed Back Surgery Syndrome in Elderly Patients: A Retrospective Study. Pain Research and Management. https://doi.org/10.1155/2023/2136562
Lee, J. Y., Sim, W. S., Kim, J. Y., Ko, Y. R., Lee, S. Y., Lee, M., Kyung, C.-M., & Park, H. J. (2020). Analysis of Subdural Injection During Lumbar Interlaminar Epidural Injection in Failed Back Surgery Syndrome. Journal of Clinical Medicine. https://doi.org/10.3390/jcm9103132
McClure, J., Desai, B., Ampie, L., You, W., Smith, J. S., & Buchholz, A. L. (2021). A Systematic Review of the Cost-Utility of Spinal Cord Stimulation for Persistent Low Back Pain in Patients With Failed Back Surgery Syndrome. Global Spine Journal. https://doi.org/10.1177/2192568220970163
Miao, J., Ailes, I., Krisa, L., Fleming, K., Middleton, D. M., Talekar, K., Natale, P., Mohamed, F. B., Hines, K., Matias, C., & Alizadeh, M. (2022). Case Report: The Promising Application of Dynamic Functional Connectivity Analysis on an Individual With Failed Back Surgery Syndrome. Frontiers in Neuroscience. https://doi.org/10.3389/fnins.2022.987223
Moisa, H. A., Nica, D. A., Popescu, E. C., Mohan, A. G., Iacob, G., & Ciurea, A. V. (2021). Current Trends in Failed Back Surgery Syndrome. Medicina Moderna - Modern Medicine. https://doi.org/10.31689/rmm.2021.28.1.13
Park, S.-H., Hur, J. W., Lee, J.-B., & Park, J. (2021). Early Clinical Outcome of Comparative Study Between Revision Operation and Radiofrequency Treatment for Management of Failed Back Surgery Syndrome. Asian Journal of Pain. https://doi.org/10.35353/ajp.2021.00017
Sabourin, S., Tram, J., Sheldon, B. L., & Pilitsis, J. G. (2021). Defining Minimal Clinically Important Differences in Pain and Disability Outcomes of Patients With Chronic Pain Treated With Spinal Cord Stimulation. Journal of Neurosurgery Spine. https://doi.org/10.3171/2020.11.spine201431
Sulaiman, A. I., Abdulmajeed, O. I., & Rashid, H. S. (2021). Presentation and Management of Failed Back Surgery Syndrome by Steerable Epidural Catheter. Journal of Sulaimani Medical College. https://doi.org/10.17656/jsmc.10313
Witkam, R. L., Buckens, C. F., Goethem, J. Van, Vissers, K., & Henssen, D. (2022). The Current Role and Future Directions of Imaging in Failed Back Surgery Syndrome Patients: An Educational Review. Insights Into Imaging. https://doi.org/10.1186/s13244-022-01246-z
Wyngaert, T. Van den. (2023). Postoperative Spine: Failed Back Surgery Syndrome (FBSS). https://doi.org/10.1007/978-3-031-26449-8_121
Yeo, J. (2024). Failed Back Surgery Syndrome—terminology, Etiology, Prevention, Evaluation, and Management: A Narrative Review. Journal of Yeungnam Medical Science. https://doi.org/10.12701/jyms.2024.00339
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