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Review
. 2016 Nov 7:9:979-987.
doi: 10.2147/JPR.S92776. eCollection 2016.

Failed back surgery syndrome: current perspectives

Zafeer Baber  1 , Michael A Erdek  1
Affiliations
Review

Failed back surgery syndrome: current perspectives

Zafeer Baber et al. J Pain Res. .

Abstract

The treatment of failed back surgery syndrome (FBSS) can be equally challenging to surgeons, pain specialists, and primary care providers alike. The onset of FBSS occurs when surgery fails to treat the patient's lumbar spinal pain. Minimizing the likelihood of FBSS is dependent on determining a clear etiology of the patient's pain, recognizing those who are at high risk, and exhausting conservative measures before deciding to go into a revision surgery. The workup of FBSS includes a thorough history and physical examination, diagnostic imaging, and procedures. After determining the cause of FBSS, a multidisciplinary approach is preferred. This includes pharmacologic management of pain, physical therapy, and behavioral modification and may include therapeutic procedures such as injections, radiofrequency ablation, lysis of adhesions, spinal cord stimulation, and even reoperations.

Keywords: back pain; back pain with radiation; back pain without radiation; low back pain; pain disorder; review; spinal cord stimulation.

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Conflict of interest statement

The authors declare no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Sacroiliac joint injection. Notes: Characteristic lateral (A) and AP (B) intra-articular sacroiliac joint (SIJ) injection. SIJ pain frequently occurs with lumbosacral fusion. The procedure can be used for both diagnostic and therapeutic purposes. Abbreviation: AP, anteroposterior.
Figure 2
Figure 2
Facet joint interventions. Notes: Fluoroscopic images of intra-articular facet blocks (A) and a lumbar medial branch block (B). Both the procedures are used as a prognostic indicator for a medial branch radiofrequency ablation. Debate as to which procedure is more accurate remains controversial.
See this image and copyright information in PMC

References

    1. Hoy D, March L, Brooks P, et al. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014;73(6):968–974. - PubMed
    1. Smith M, Davis MA, Stano M, Whedon JM. Aging baby boomers and the rising cost of chronic back pain: secular trend analysis of longitudinal Medical Expenditures Panel Survey data for years 2000 to 2007. J Manipulative Physiol Ther. 2013;36(1):2–11. - PMC - PubMed
    1. Rajaee SS, Bae HW, Kanim LE, Delamarter RB. Spinal fusion in the United States: analysis of trends from 1998 to 2008. Spine. 2012;37(1):67–76. - PubMed
    1. Harvey AM. Classification of chronic pain – descriptions of chronic pain syndromes and definitions of pain terms. Clin J Pain. 1995;11(2):163.
    1. Thomson S. Failed back surgery syndrome – definition, epidemiology and demographics. Br J Pain. 2013;7(1):56–59. - PMC - PubMed