Lateral Recess Stenosis as a Cause for Failed Back Surgery

Abstract

Background: Lateral recess stenosis constitutes forty percent of causes of failed-back surgery and present with radicular pain which increases with exercise, decreases on rest and have intermittent claudication character. The study aims to identify symptomatology and natural history of the disease pre and postoperatively. Identifying the exact nature of the pathology by CT scan. the determination which group of patients needs a preoperative CT scan of the lower lumbar vertebrae depending on clinical features for measuring the lateral recess.

Patients: A total of 24 patients with failed back surgery in whom other causes of failed back surgery were excluded other than lateral stenosis. Mosul teaching hospital neurosurgical department.

Results: Lateral stenosis causes pain of specific criteria in the age group over forty years, it occurs in multiple levels and increases in severity from up-down, the severity differs in both sides at the same level and is correlated to symptoms. The laminectomy may not decompress the lateral recess adequately.

Conclusion: CT scan of the lumbar vertebrae is indicated preoperatively for patients with disc prolapse and\ or stenosis in the age group over forty and has certain criteria in their disease history.