Undiagnosed Peripheral Nerve Disease in Patients with Failed Lumbar Disc Surgery
10.31616/asj.2018.12.4.720
- Author:
Tomohiro YAMAUCHI
1
;
Kyongsong KIM
;
Toyohiko ISU
;
Naotaka IWAMOTO
;
Kazuyoshi YAMAZAKI
;
Juntaro MATSUMOTO
;
Masanori ISOBE
Author Information
1. Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido, Japan. kyongson@nms.ac.jp
- Publication Type:Original Article
- Keywords:
Low back pain;
Peripheral nerve;
Lumbosacral region;
Intervertebral disc disease;
Nerve compression syndrome
- MeSH:
Diskectomy;
Failed Back Surgery Syndrome;
Humans;
Leg;
Low Back Pain;
Lumbosacral Region;
Nerve Compression Syndromes;
Peripheral Nerves;
Peripheral Nervous System Diseases;
Peroneal Nerve;
Retrospective Studies;
Spine;
Tarsal Tunnel Syndrome
- From:Asian Spine Journal
2018;12(4):720-725
- CountryRepublic of Korea
- Language:English
-
Abstract:
STUDY DESIGN: Retrospective study (level of evidence=3). PURPOSE: We examine the relationship between residual symptoms after discectomy for lumbar disc herniation and peripheral nerve (PN) neuropathy. OVERVIEW OF LITERATURE: Patients may report persistent or recurrent symptoms after lumbar disc herniation surgery; others fail to respond to a variety of treatments. Some PN neuropathies elicit symptoms similar to those of lumbar spine disease. METHODS: We retrospectively analyzed data for 13 patients treated for persistent (n=2) or recurrent (n=11) low back pain (LBP) and/or leg pain after primary lumbar discectomy. RESULTS: Lumbar re-operation was required for four patients (three with recurrent lumbar disc herniation and one with lumbar canal stenosis). Superior cluneal nerve (SCN) entrapment neuropathy (EN) was noted in 12 patients; SCN block improved the symptoms for eight of these patients. In total, nine patients underwent PN surgery (SCN-EN, n=4; peroneal nerve EN, n=3; tarsal tunnel syndrome, n=1). Their symptoms improved significantly. CONCLUSIONS: Concomitant PN disease should be considered for patients with failed back surgery syndrome manifesting as persistent or recurrent LBP.
