Failed Back Surgery Syndrome

Abstract

FBSS is a challenging clinical entity with significant impact on the individual and society. To better prevent and manage this condition, knowledge of the factors contributing to its development is necessary. While research on FBSS has increased in recent years, perhaps the best strategy to reduce incidence and morbidity is to focus on prevention. Patients diagnosed with FBSS should be managed in an interdisciplinary environment. More radical treatments for FBSS have now been extensively studied providing clinicians with much needed evidence on their efficacy. Incorporating these results into our current knowledge provides a basis on which to construct an evidence-based guide on how best to manage patients who suffer from FBSS.

Chiropractic management of postoperative spine pain: a report of 3 cases

“…Chronic neck pain post-cervical spine fusion is common and may be attributed to numerous factors including surgery at the wrong level, insufficient removal of herniated or degenerative tissues, unrecognized second disk herniation, recurrence of herniation, unrecognized displaced sequestration, new disk herniation at a different level, epidural fibrosis/local arachnoiditis, or symptomatic arthritis of the posterior joints. 34 Additionally, in the untreated adjacent levels, increased motion and elevated intradiscal pressures have been associated with an increased risk of adjacent level syndrome, 35 believed to be the cause of 25% of post-cervical fusion pain. 36 Moreover, current evidence suggests that the zygoapophyseal joint is the most common cause of posttraumatic chronic neck pain.…”

Not the Last Word: Choosing Wisely

“…• ''Spinal fusion, when it works, is a wonderful operation, but when it does not, it can be horrid. In fact, there is an entire diagnostic category, ''failed back surgery syndrome'' [17], to describe patients who are substantially worse after spinal surgery. Choose wisely.''…”

Leukocytosis of Unknown Etiology in a Patient with a Spinal Cord Stimulator

“…FBSS impacted health care and has been a significant cause of disability in patients suffering from low back pain [1]. Despite the improvement in surgical techniques and technology, FBSS continues to prevail [2][3][4]. Numerous modalities have been used to treat FBSS, including injections, physical therapy and medications, but there is a subset of patients that persist with pain.…”