Correlations of the Clinical Factors and Gait Parameters in Failed Back Surgery Syndrome

OBJECTIVE: To analyze the relationship of clinical factors and gait parameters of patients with failed back surgery syndrome. METHOD: We investigated 25 male patients with back and /or lower limb pain who underwent lumbar spine operation. The following data were evaluated: clinical symptoms, physical examination, duration from operation to the gait analysis, number and level of operation, Visual Analogue Scales (VAS), modified Dallas pain questionnaire, psychological evaluations (Beck Depression Inventory, BDI) and gait parameters through 3 dimensional gait analysis. RESULTS: Walking velocity was inversely correlated with scores of modified Dallas pain questionnaire and BDI. Stride length was inversely correlated with scores of return to work, neurogenic claudication, VAS, modified Dallas pain questionnaire and BDI. Range of pelvic obliquity was inversely correlated with scores of modified Dallas pain questionnaire and BDI. There was no significant differences between findings of physical exam and gait parameters. CONCLUSION: Results of the gait analysis of patients with failed back surgery syndrome showed significant relationship with clinical factors reflecting psychosocial background of patients.

Evaluation of Epidural Injection with Modified Dallas Pain Questionnaire in Patients with Low Back Pain

OBJECTIVE: To evaluate the efficacy of epidural injections of steroid and local anesthetics with the modified Dallas pain questionnaire in the low back pain patients. METHOD: Before and after epidural injections with triamcinolone and local anesthetics, we examined the patients with modified Dallas pain questionnaire. The efficacy was assessed by paired t test to compare the results of this questionnaire. RESULTS: Four aspects of the patient's life (daily activity, work and leisure activity, anxiety- depression, and social interest) were significantly improved after epidural injection in low back pain patients. And their improvements were more definite in patients diagnosed with herniatied lumbar disc, relatively acute onset of symptom, and more serious findings in MRI. CONCLUSION: Epdiural injections of steroid and local anesthetics are effective for patients with low back pain, espercially for improving life quality of patients such as daily activity and work-leisure activity. It also decreases anxiety and increases social interest in some patients. However, validity of modified Dallas pain questionnaire must be proved in the future.