Background: Post lumbar surgery syndrome refers to pain occurring or present after lumbar surgery.
While the causes of pain after lumbar surgery are multi-factorial, scarring is a significant source of
that pain. Low back and/or leg pain after lumbar surgery can persist despite appropriate conservative
therapy. Spinal endoscopy allows direct visual evaluation of the epidural space, along with mechanical
lysis of any adhesions present.
Study Design: A systematic review of the effectiveness of spinal endoscopic adhesiolysis in post
lumbar surgery syndrome.
Objective: To evaluate and update the effectiveness of spinal endoscopic adhesiolysis in treating
post lumbar surgery syndrome.
Methods: The available literature on spinal endoscopic adhesiolysis in treating post lumbar surgery
syndrome was reviewed. The quality assessment and clinical relevance criteria utilized were the Cochrane
Musculoskeletal Review Group criteria as utilized for interventional techniques for randomized trials and
the criteria developed by the Newcastle-Ottawa Scale criteria for observational studies.
The level of evidence was classified as good, fair, and limited or poor based on the quality of evidence
developed by the U.S. Preventive Services Task Force (USPSTF).
Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966
to September 2012, and manual searches of the bibliographies of known primary and review articles.
Outcome Measures: Pain relief and functional improvement were the primary outcome measures.
Other outcome measures were improvement of psychological status, opioid intake, and return to work.
Short-term effectiveness was defined as improvement of 12 months or less; whereas, long-term
effectiveness was defined 12 months or longer.
Results: For this systematic review, 21 studies were identified. Of these, one randomized controlled
trial (RCT) and 5 observational studies met the inclusion criteria. Two of the observational studies were
excluded because of other methodological issues, despite showing positive outcomes.
Using current criteria for successful outcomes, these studies indicate that there is fair evidence for
the effectiveness of spinal endoscopy in the treatment of persistent low back and/or leg pain in post
lumbar surgery syndrome.
Limitations: The limitations of this systematic review include the paucity of literature.
Conclusion: The evidence is fair that spinal endoscopy is effective in the treatment of post lumbar
surgery syndrome.
Key words: Spinal pain, chronic low back pain, post lumbar surgery syndrome, epidural scarring,
adhesiolysis, endoscopy
Effect of Neural Mobilization Exercises in Patients With Low Back-Related Leg Pain With Peripheral Nerve Sensitization: A Prospective, Controlled Trial
