Anesthesiology and Pain Medicine

Published by: Kowsar

The Results of Treating Failed Back Surgery Syndrome by Adhesiolysis: Comparing the One- and Three-Day Protocols

Behnam Hossieni 1 , Payman Dadkhah 1 , Siamak Moradi 1 , Seyed Masoud Hashemi 1 , * and Farshad Safdari 2
Authors Information
1 Clinical Research Development Unit, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Orthotist and Prosthetist, Bone Joint and Related Tissues Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Article information
  • Anesthesiology and Pain Medicine: October 2017, 7 (5); e60271
  • Published Online: August 22, 2017
  • Article Type: Research Article
  • Received: June 22, 2016
  • Revised: February 13, 2017
  • Accepted: April 25, 2017
  • DOI: 10.5812/aapm.60271

To Cite: Hossieni B, Dadkhah P, Moradi S, Hashemi S M, Safdari F. The Results of Treating Failed Back Surgery Syndrome by Adhesiolysis: Comparing the One- and Three-Day Protocols, Anesth Pain Med. 2017 ; 7(5):e60271. doi: 10.5812/aapm.60271.

Copyright © 2017, Anesthesiology and Pain Medicine. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Methods
3. Results
4. Discussion
  • 1. Rahimzadeh P, Sharma V, Imani F, Faiz HR, Ghodraty MR, Nikzad-Jamnani AR, et al. Adjuvant hyaluronidase to epidural steroid improves the quality of analgesia in failed back surgery syndrome: a prospective randomized clinical trial. Pain Physician. 2014; 17(1)-82[PubMed]
  • 2. Bokov A, Isrelov A, Skorodumov A, Aleynik A, Simonov A, Mlyavykh S. An analysis of reasons for failed back surgery syndrome and partial results after different types of surgical lumbar nerve root decompression. Pain Physician. 2011; 14(6): 545-57[PubMed]
  • 3. Hua S, Levy R. Essentials of Pain Medicine and Regional Anesthesia. 1999;
  • 4. Manchikanti L, Singh V, Cash KA, Pampati V, Datta S. A comparative effectiveness evaluation of percutaneous adhesiolysis and epidural steroid injections in managing lumbar post surgery syndrome: a randomized, equivalence controlled trial. Pain Physician. 2009; 12(6)-68[PubMed]
  • 5. Bujedo BM. Treatment of failed back surgery syndrome in a forty-three-year-old man with high-dose oxycodone/naloxone. Anesth Pain Med. 2015; 5(2)[DOI][PubMed]
  • 6. Frey ME, Manchikanti L, Benyamin RM, Schultz DM, Smith HS, Cohen SP. Spinal cord stimulation for patients with failed back surgery syndrome: a systematic review. Pain Physician. 2009; 12(2): 379-97[PubMed]
  • 7. Chan CW, Peng P. Failed back surgery syndrome. Pain Med. 2011; 12(4): 577-606[DOI][PubMed]
  • 8. Chun-jing H, Hao-xiong N, jia-xiang N. The application of percutaneous lysis of epidural adhesions in patients with failed back surgery syndrome. Acta Cir Bras. 2012; 27(4): 357-62[PubMed]
  • 9. Hou JC, Zheng TY, Li DY, Zhi MX. [Sacrococcygeal gap injection for the treatment of failed back surgery syndrome]. Zhongguo Gu Shang. 2014; 27(3): 229-31[PubMed]
  • 10. Hsu E, Atanelov L, Plunkett AR, Chai N, Chen Y, Cohen SP. Epidural lysis of adhesions for failed back surgery and spinal stenosis: factors associated with treatment outcome. Anesth Analg. 2014; 118(1): 215-24[DOI][PubMed]
  • 11. Hussain A, Erdek M. Interventional pain management for failed back surgery syndrome. Pain Pract. 2014; 14(1): 64-78[DOI][PubMed]
  • 12. Jamison DE, Hsu E, Cohen SP. Epidural adhesiolysis: an evidence-based review. J Neurosurg Sci. 2014; 58(2): 65-76[PubMed]
  • 13. Kat'uch V, Pataky F, Kat'uchova J, Gajdos M, Radonak J. [Surgical management of the failed back surgery syndrome (FBSS) using posterior lumbar interbody fusion (PLIF) with posterior transpedicular stabilization]. Rozhl Chir. 2010; 89(7): 450-8[PubMed]
  • 14. Kelly GA, Blake C, Power CK, O'Keeffe D, Fullen BM. The impact of spinal cord stimulation on physical function and sleep quality in individuals with failed back surgery syndrome: a systematic review. Eur J Pain. 2012; 16(6): 793-802[DOI][PubMed]
  • 15. Khosravi MB, Azemati S, Sahmeddini MA. Gabapentin versus naproxen in the management of failed back surgery syndrome; a randomized controlled trial. Acta Anaesthesiol Belg. 2014; 65(1): 31-7[PubMed]
  • 16. Manchikanti L, Manchikanti KN, Gharibo CG, Kaye AD. Efficacy of Percutaneous Adhesiolysis in the Treatment of Lumbar Post Surgery Syndrome. Anesth Pain Med. 2016; 6(2)[DOI][PubMed]
  • 17. Manchikanti L, Singh V, Cash KA, Pampati V, Datta S. Management of pain of post lumbar surgery syndrome: one-year results of a randomized, double-blind, active controlled trial of fluoroscopic caudal epidural injections. Pain Physician. 2010; 13(6): 509-21[PubMed]
  • 18. Taheri A, Khajenasiri AR, Yazdi NN, Safari S, Sadeghi J, Hatami M. Clinical Evaluation of Percutaneous Caudal Epidural Adhesiolysis With the Racz Technique for Low Back Pain Due to Contained Disc Herniation. Anesth Pain Med. 2016; 6(3)[DOI]
  • 19. Reverberi C, Dario A, Barolat G. Spinal cord stimulation (SCS) in conjunction with peripheral nerve field stimulation (PNfS) for the treatment of complex pain in failed back surgery syndrome (FBSS). Neuromodulation. 2013; 16(1): 78-82[DOI][PubMed]
  • 20. Sears NC, Machado AG, Nagel SJ, Deogaonkar M, Stanton-Hicks M, Rezai AR, et al. Long-term outcomes of spinal cord stimulation with paddle leads in the treatment of complex regional pain syndrome and failed back surgery syndrome. Neuromodulation. 2011; 14(4): 312-8[DOI][PubMed]
  • 21. Teixeira MJ, Yeng LT, Garcia OG, Fonoff ET, Paiva WS, Araujo JO. Failed back surgery pain syndrome: therapeutic approach descriptive study in 56 patients. Rev Assoc Med Bras (1992). 2011; 57(3): 282-7[PubMed]
  • 22. Tomycz ND, Ortiz V, Moossy JJ. Simultaneous intrathecal opioid pump and spinal cord stimulation for pain management: analysis of 11 patients with failed back surgery syndrome. J Pain Palliat Care Pharmacother. 2010; 24(4): 374-83[DOI][PubMed]
  • 23. Turner JA, Hollingworth W, Comstock BA, Deyo RA. Spinal cord stimulation for failed back surgery syndrome: outcomes in a workers' compensation setting. Pain. 2010; 148(1): 14-25[DOI][PubMed]
  • 24. Waikakul S. Serum 25-hydroxy-calciferol level and failed back surgery syndrome. J Orthop Surg (Hong Kong). 2012; 20(1): 18-22[DOI][PubMed]
  • 25. Patel VB, Wasserman R, Imani F. Interventional Therapies for Chronic Low Back Pain: A Focused Review (Efficacy and Outcomes). Anesth Pain Med. 2015; 5(4)[DOI][PubMed]
  • 26. Safaeian P, Mattie R, Hahn M, Plastaras C T, McCormick Z L, et al. Novel Treatment of Radicular Pain With a Multi-Mechanistic Combination Topical Agent: A Case Series and Literature Review. Anesth Pain Med. 2016; 6(2)[DOI]
  • 27. Ross JS, Robertson JT, Frederickson RC, Petrie JL, Obuchowski N, Modic MT, et al. Association between peridural scar and recurrent radicular pain after lumbar discectomy: magnetic resonance evaluation. ADCON-L European Study Group. Neurosurgery. 1996; 38(4): 855-61[PubMed]
  • 28. Maroon JC, Abla A, Bost J. Association between peridural scar and persistent low back pain after lumbar discectomy. Neurol Res. 1999; 21 Suppl 1-6[PubMed]
  • 29. Ronnberg K, Lind B, Zoega B, Gadeholt-Gothlin G, Halldin K, Gellerstedt M, et al. Peridural scar and its relation to clinical outcome: a randomised study on surgically treated lumbar disc herniation patients. Eur Spine J. 2008; 17(12): 1714-20[DOI][PubMed]
  • 30. Lee F, Jamison DE, Hurley RW, Cohen SP. Epidural lysis of adhesions. Korean J Pain. 2014; 27(1): 3-15[DOI][PubMed]
  • 31. Abeloos L, De Witte O, Riquet R, Tuna T, Mathieu N. [Long-term outcome of patients treated with spinal cord stimulation for therapeutically refractory failed back surgery syndrome: a retrospective study]. Neurochirurgie. 2011; 57(3): 114-9[DOI][PubMed]
  • 32. Imani F, Rahimzadeh P. Interventional pain management according to evidence-based medicine. Anesth Pain Med. 2012; 1(4): 235-6[DOI][PubMed]
  • 33. Manchikanti L, Singh V, Cash KA, Pampati V, Datta S. Preliminary results of a randomized, equivalence trial of fluoroscopic caudal epidural injections in managing chronic low back pain: Part 3--Post surgery syndrome. Pain Physician. 2008; 11(6): 817-31[PubMed]
  • 34. Lee JH, Lee SH. Clinical effectiveness of percutaneous adhesiolysis versus transforaminal epidural steroid injection in patients with postlumbar surgery syndrome. Reg Anesth Pain Med. 2014; 39(3): 214-8[DOI][PubMed]
  • 35. Manchikanti L, Singh V, Cash KA, Pampati V. Assessment of effectiveness of percutaneous adhesiolysis and caudal epidural injections in managing post lumbar surgery syndrome: 2-year follow-up of a randomized, controlled trial. J Pain Res. 2012; 5: 597-608[DOI][PubMed]
  • 36. Racz GB, Heavner JE, Diede JH. 1996; : 339-51
  • 37. Manchikanti L, Pakanati RR, Bakhit CE, Pampafi V. Role of Adhesiolysis and Hypertonic Saline Neurolysis in Management of Low Back Pain: Evaluation of Modification of the Racz Protocol. Pain Dig. 1999; 9: 91-6
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