[The so-called post-discotomy syndrome--failure of intervertebral disk surgery?]

The Post-discectomy-Syndrome (PDS) is a clinical entity with various components from individual disposition, sequelae of the underlying disc degeneration and of the operation, as well. These include local back pain, persisting (poly-)radicular pain and facet irritation with pseudoradicular irradiation due to segmental instability, epidural scarring and local arachnoiditis. Diagnosis has to focus on separation from failed-back-surgery-syndromes (FBSS) with single components like insufficient discal or bony decompression or segmental instability. Arachnoiditis seems to be the least modifiable factor and should be excluded if fusion or revision of the spinal canal is planned. A 100 point-score for grading of PDS is presented.