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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Synonyms
Epidural fibrosis, epidural scar
Definitions
Scar formation within epidural space after lumbar surgery
Part of failed back surgery syndrome (FBSS)
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Nonvascular Interventions
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Akbas M et al: Comparison of 3 approaches to percutaneous epidural adhesiolysis and neuroplasty in post lumbar surgery syndrome. Pain Physician. 21(5):E501-8, 2018
Pereira P et al: New insights from immunohistochemistry for the characterization of epidural scar tissue. Pain Physician. 17(5):465-74, 2014
Willson MC et al: Postoperative spine complications. Neuroimaging Clin N Am. 24(2):305-26, 2014
Rönnberg K et al: Peridural scar and its relation to clinical outcome: a randomised study on surgically treated lumbar disc herniation patients. Eur Spine J. 17(12):1714-20, 2008
Ganzer D et al: Two-year results after lumbar microdiscectomy with and without prophylaxis of a peridural fibrosis using Adcon-L. Arch Orthop Trauma Surg. 123(1):17-21, 2003
Van Goethem JW et al: Review article: MRI of the postoperative lumbar spine. Neuroradiology. 44(9):723-39, 2002
Anderson SR: A rationale for the treatment algorithm of failed back surgery syndrome. Curr Rev Pain. 4(5):395-406, 2000
Anderson VC et al: Failed back surgery syndrome. Curr Rev Pain. 4(2):105-11, 2000
Coskun E et al: Relationships between epidural fibrosis, pain, disability, and psychological factors after lumbar disc surgery. Eur Spine J. 9(3):218-23, 2000
Pearce JM: Aspects of the failed back syndrome: role of litigation. Spinal Cord. 38(2):63-70, 2000
Samy Abdou M et al: Epidural fibrosis and the failed back surgery syndrome: history and physical findings. Neurol Res. 21 Suppl 1:S5-8, 1999
Fritsch EW et al: The failed back surgery syndrome: reasons, intraoperative findings, and long-term results: a report of 182 operative treatments. Spine. 21(5):626-33, 1996
Georgy BA et al: Fat-suppression contrast-enhanced MRI in the failed back surgery syndrome: a prospective study. Neuroradiology. 37(1):51-7, 1995
North RB et al: Failed back surgery syndrome: 5-year follow-up in 102 patients undergoing repeated operation. Neurosurgery. 28(5):685-90; discussion 690-1, 1991
Bundschuh CV et al: Distinguishing between scar and recurrent herniated disk in postoperative patients: value of contrast-enhanced CT and MR imaging. AJNR Am J Neuroradiol. 11(5):949-58, 1990
Djukic S et al: Magnetic resonance imaging of the postoperative lumbar spine. Radiol Clin North Am. 28(2):341-60, 1990
Ross JS et al: MR imaging of the postoperative lumbar spine: assessment with gadopentetate dimeglumine. AJNR Am J Neuroradiol. 11(4):771-6, 1990
Ross JS et al: MR imaging of the postoperative lumbar spine: assessment with gadopentetate dimeglumine. AJR Am J Roentgenol. 155(4):867-72, 1990
Hueftle MG et al: Lumbar spine: postoperative MR imaging with Gd-DTPA. Radiology. 167(3):817-24, 1988
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Synonyms
Epidural fibrosis, epidural scar
Definitions
Scar formation within epidural space after lumbar surgery
Part of failed back surgery syndrome (FBSS)
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Nonvascular Interventions
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Akbas M et al: Comparison of 3 approaches to percutaneous epidural adhesiolysis and neuroplasty in post lumbar surgery syndrome. Pain Physician. 21(5):E501-8, 2018
Pereira P et al: New insights from immunohistochemistry for the characterization of epidural scar tissue. Pain Physician. 17(5):465-74, 2014
Willson MC et al: Postoperative spine complications. Neuroimaging Clin N Am. 24(2):305-26, 2014
Rönnberg K et al: Peridural scar and its relation to clinical outcome: a randomised study on surgically treated lumbar disc herniation patients. Eur Spine J. 17(12):1714-20, 2008
Ganzer D et al: Two-year results after lumbar microdiscectomy with and without prophylaxis of a peridural fibrosis using Adcon-L. Arch Orthop Trauma Surg. 123(1):17-21, 2003
Van Goethem JW et al: Review article: MRI of the postoperative lumbar spine. Neuroradiology. 44(9):723-39, 2002
Anderson SR: A rationale for the treatment algorithm of failed back surgery syndrome. Curr Rev Pain. 4(5):395-406, 2000
Anderson VC et al: Failed back surgery syndrome. Curr Rev Pain. 4(2):105-11, 2000
Coskun E et al: Relationships between epidural fibrosis, pain, disability, and psychological factors after lumbar disc surgery. Eur Spine J. 9(3):218-23, 2000
Pearce JM: Aspects of the failed back syndrome: role of litigation. Spinal Cord. 38(2):63-70, 2000
Samy Abdou M et al: Epidural fibrosis and the failed back surgery syndrome: history and physical findings. Neurol Res. 21 Suppl 1:S5-8, 1999
Fritsch EW et al: The failed back surgery syndrome: reasons, intraoperative findings, and long-term results: a report of 182 operative treatments. Spine. 21(5):626-33, 1996
Georgy BA et al: Fat-suppression contrast-enhanced MRI in the failed back surgery syndrome: a prospective study. Neuroradiology. 37(1):51-7, 1995
North RB et al: Failed back surgery syndrome: 5-year follow-up in 102 patients undergoing repeated operation. Neurosurgery. 28(5):685-90; discussion 690-1, 1991
Bundschuh CV et al: Distinguishing between scar and recurrent herniated disk in postoperative patients: value of contrast-enhanced CT and MR imaging. AJNR Am J Neuroradiol. 11(5):949-58, 1990
Djukic S et al: Magnetic resonance imaging of the postoperative lumbar spine. Radiol Clin North Am. 28(2):341-60, 1990
Ross JS et al: MR imaging of the postoperative lumbar spine: assessment with gadopentetate dimeglumine. AJNR Am J Neuroradiol. 11(4):771-6, 1990
Ross JS et al: MR imaging of the postoperative lumbar spine: assessment with gadopentetate dimeglumine. AJR Am J Roentgenol. 155(4):867-72, 1990
Hueftle MG et al: Lumbar spine: postoperative MR imaging with Gd-DTPA. Radiology. 167(3):817-24, 1988
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