J Yeungnam Med Sci.  2024 Jul;41(3):166-178. 10.12701/jyms.2024.00339.

Failed back surgery syndrome—terminology, etiology, prevention, evaluation, and management: a narrative review

• Yeo J

• KMID: 2558141
• DOI: http://doi.org/10.12701/jyms.2024.00339

Abstract

Amid the worldwide increase in spinal surgery rates, a significant proportion of patients continue to experience refractory chronic pain, resulting in reduced quality of life and escalated healthcare demands. Failed back surgery syndrome (FBSS) is a clinical condition characterized by persistent or recurrent pain after one or more spinal surgeries. The diverse characteristics and stigmatizing descriptions of FBSS necessitate a reevaluation of its nomenclature to reflect its complexity more accurately. Accurate identification of the cause of FBSS is hampered by the complex nature of the syndrome and limitations of current diagnostic labels. Management requires a multidisciplinary approach that may include pharmacological treatment, physical therapy, psychological support, and interventional procedures, emphasizing realistic goal-setting and patient education. Further research is needed to increase our understanding, improve diagnostic accuracy, and develop more effective management strategies.

Keyword

Back pain; Chronic pain; Failed back surgery syndrome

Figure

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  Fig. 1. Adjacent segment degeneration. (A) Plain radiograph and (B) magnetic resonance image of a patient who had undergone a two-level lumbar spinal fusion from L3 to L5 2 years earlier. The magnetic resonance image reveals a herniated disc at the L3-L4 level.

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  Fig. 2. Mechanical adhesiolysis is performed with an epiduroscope. The fluoroscopic image shows the tip of the epiduroscope at the left L5/S1 intervertebral foramen.

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  Fig. 3. Spinal cord stimulator implantation. The image shows that the electrodes are implanted at the T8–T11 vertebral levels.

Reference

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