1/3 of patients with cervical/lumbar radicolopathy show a FBSS („failed back surgery syndrome“). What is your experience with "postdiskektomie"- or "postnukleotomie-Syndromes" in neurosurgery and orthopedic surgery, neurology and rehabilitation?
For the treatment of FBSS we use intraosseous blockades with a pronounced therapeutic effect. www.pain-clinic.ru
PDS/PNS are very frequent syndromes. In our department we try to perform single sequesterectomies. Our experiences and also literatur show that the rate of PNS is much lower compared to nucleotomies. But every alteration of spinal dynamic might result in chronic lower back pain. CAVE: surgery should not always be the first choice.
Thank you, Evgeny, for your interesting message. As your homepage in russian language is hard to read for me, I like to ask you for more details in english or french?
Many thanks for your answer from Innsbruck, Jochen, my short report (attachment) shows some epidemiologic numbers (out of our new textbook). Single sequesterectomies seem to be more succsessfull.
I agree with you: surgery should not be the first choice. I think that we should always speak (trying a dialogue like "active listening") with the acute as well chronic (low) back pain patients.
Кarl, thank you for your interest in our method and site. I look forward to your questions. Evgeny Sokov
Evgeny, please give me a short example of your method, special technique, frequency of treatment and outcome.
Hello Karl and others,
You started an interesting discussion. This is a major societal problem and as neurosurgeons we have neglected that part. Although our results with sequestrectomies are hopeful we do keep patients with persistent nerve pain. Next year at the international pain congres in buenos aires we will create a separate session.
In particular after our recent MRI study in sciatica patients does show that for many patients we couldn't find a structural anatomical compression, suggesting intranerval problems, like we thought centuries ago.
Good to build an international forum.
Greetings
wilco
Hello, to illustrate the point, I add a MRI-imaging of the lumbar spine and an actual textbook page with these images (in print):
A patient (53) suffering 8 weeks from pain and sensomotor paresis, agreed to neurosurgy exploration, which could not find anymore (b) the former sequester L5/S1 (a).
Thnx, the issue is that we do not haven any real scientific evidence of the pain generation after compression of the spinal nerve. is challenging subject for research.
The best is prevent PDS/PNS.The prevent is for surgery precise diagnostic LBP sy and good indication for surgery.Important is also select sufficient operation instrumentation(open,micro, MAST etd.)
Chiropractic Management of Postsurgical Lumbar Spine Pain: A Retrospective Study of 32 Cases
Ralph A. Kruse, DC
,
Jerrilyn Cambron, DC, PhD
Especially with the failed surgical cases the issue is that nothing has been done to change the underlying biomechanics.
Check http://www.meningealrelease.com/articles/multiple-sclerosis-and-cerebral-palsey-mechanisms Same mechanism in these cases.
check the rest of MeningealRelease.com for methods to handle.
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