The role of epidural fibrosis and defective fibrinolysis in the persistence of postlaminectomy back pain

Clinical features, contrast-enhanced lumbar tomographic findings, and biochemical plasma fibrinolytic parameters were critically assessed in 70 patients suffering severe, chronic postsurgical low-back and radicular pain to determine the cause of their persisting symptoms. Patients exhibited gross fu...

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Bibliographic Details
Published inSpine (Philadelphia, Pa. 1976) Vol. 16; no. 9; p. 1044
Main Authors Cooper, R G, Mitchell, W S, Illingworth, K J, Forbes, W S, Gillespie, J E, Jayson, M I
Format Journal Article
LanguageEnglish
Published United States 01.09.1991
Subjects
Arachnoiditis - blood
Arachnoiditis - etiology
Back Pain - blood
Back Pain - etiology
Epidural Space - pathology
Female
Fibrinolysis - physiology
Fibrosis
Humans
Laminectomy
Male
Middle Aged
Pain, Postoperative - blood
Pain, Postoperative - etiology
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Summary:Clinical features, contrast-enhanced lumbar tomographic findings, and biochemical plasma fibrinolytic parameters were critically assessed in 70 patients suffering severe, chronic postsurgical low-back and radicular pain to determine the cause of their persisting symptoms. Patients exhibited gross functional disability and significant impairment of plasma fibrinolytic activity, compared with 84 normal control subjects. This fibrinolytic defect appeared attributable to disproportionate increases in circulating plasminogen activator inhibitor-1 levels. Clinical features were slightly worse in patients with radiologic epidural fibrosis, whereas the frequency of radiologic abnormalities, including epidural fibrosis, was higher in patients with fibrinolytic abnormalities. The results, however, demonstrated no significant associations between patients' symptoms and signs and their biochemical and radiologic abnormalities.
ISSN:0362-2436
DOI:10.1097/00007632-199109000-00005