Journal of Medical Sciences · Published 2025-06-26 · DOI 10.4103/jmedsci.jmedsci_239_24
Background: Postlaminectomy pain syndrome (PLPS), also referred to as failed back surgery syndrome, represents a complex clinical entity characterized by persistent or recurrent lower back pain, with or without radicular symptoms, following spinal surgery. Despite advancements in surgical techniques, the management of PLPS remains challenging due to its multifactorial and heterogeneous etiologies. Aim: This study aimed to evaluate the efficacy of posterior lumbar interbody fusion (PLIF) in improving clinical and radiologic outcomes for patients with PLPS due to surgically correctable structural causes. Methods: A retrospective study was conducted on 64 patients (mean age: 48.2 years, range: 34–75 years) who underwent PLIF by a single surgeon from 2014 to 2018. Clinical outcomes were assessed using the Visual Analog Scale (VAS) for pain and Japanese Orthopaedic Association (JOA) scores. Radiologic evaluation included flexion/extension X-rays to determine fusion rates. Patients were followed up for a mean of 3.5 years (range: 2–6 years). Results: VAS scores improved from a preoperative mean of 8.5–1.9 at the final follow-up, while JOA scores increased from 9.3 to 23.1 (P < 0.001). The mean recovery rate was 79.1%, with a fusion rate of 88.7%. Complications included dural tears in 9.3% of cases, with no nerve root injuries. Satisfactory outcomes were reported in 79.7% of patients. Conclusion: PLIF is a safe and effective revision procedure for PLPS, offering substantial improvements in pain, function, and spinal stability. Its versatility makes it a viable option for addressing diverse structural causes of PLPS.
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