الفهرس 
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Abstract
In this thesis, 50 Patients with failed back surgery syndrome with surgically corrected causes were admitted in the Neurosurgical department, Menoufiya University hospital where they managed and operated by either decompression and/or fixation.
Failed back surgery syndrome (FBSS) is a term used to encompass a heterogeneous group of patients who have persistent symptoms of back and leg pain despite surgical therapy (Anderson, 2000).
The aim of the work is to evaluate the possible causes of failed back surgery syndrome and find out the best methods of prevention and treatment of such a problem.
All patients were subjected to thorough clinical examination according to the neuroldgicaTsheet applied in this1 study.
The average age of our patients was 42.7 years. The vast majority of cases (35 cases 70 %) occurred in the: 4th and the 5th decades (middle age groups).
Male patients were commonly affected than females in ratio of 1.36:1, 26 cases (52 %) of the patients did hard work, 16 cases (32 %) were house wives and 8 cases 16 %’ had sedent’ary ’life style. ’
The duration of symptoms free interval after the first operation in our study ranged from one month to twenty- three years with an average of 2 years and seven months,
The commonest main presenting complaint was sciatica in 41 cases (82%); unilateral: in 29 cases (58%) and bilateral in 12 cases (24%). The next presenting ”isymptoni” was back* ’pain1 in 24 cases (48%), neurogenic claudication pain in 8 cases (16%) then motor affection in 5 cases (10%).
By examination, the commonest sign was sensory radicular affection in 46 cases (92%) then positive straight leg raising test in 41 cases (82%) then lost ankle reflexes in 28 cases (56%). Motor weakness presented in 7 cases (14%) and tender lower back in 17. cases (34%).