Failed back syndromes: opinions and personal experiences

The authors consider poor results in lumbar disc surgery to be commonly caused by the following conditions: 1) recurrence of the hernia; 2) postoperative instability; 3) scarring entrapment of the spinal nerve roots; 4) coexisting local or general pathology; 5) arachnoiditis; 6) psychological causes and those where insurance is involved. In particular patients with insurance-related motivations or those affected with depressive syndromes are frequently observed among those submitted to lumbar surgery. The only indications for surgery include recurrence of disc herniation and postoperative instability. In any of the other situations further surgery often results in worsening of the patient's conditions, or it at any rate does not guarantee improvement in the conditions of the patients.