Multiple spine surgical failures. The value of adjunctive psychological assessment.

The results of a retrospective 44-patient study of vocationally disabled patients who had undergone unsuccessful traditional lumbar spine surgical procedures for low back pain and/or lower extremity sciatic pain are presented. It was found that errors in patient selection and patient psychosocial pathology may have been contributory to the failures. If identified preoperatively, these conditions might have contraindicated one or more of the surgical procedures. The 24-month study required the completion of the Minnesota Multiphasic Personality Inventory by each patient; this test aids identification of patients who will be better served by treatment interventions other than surgery, or who may require psychological perioperative care.