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

Abstract:

: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.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Cooper RG,Mitchell WS,Illingworth KJ,Forbes WS,Gillespie JE,Jayson MI

doi

10.1097/00007632-199109000-00005

subject

Has Abstract

pub_date

1991-09-01 00:00:00

pages

1044-8

issue

9

eissn

0362-2436

issn

1528-1159

journal_volume

16

pub_type

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