British journal of pain
-
British journal of pain · Feb 2013
Failed back surgery syndrome - definition, epidemiology and demographics.
Failed back surgery syndrome is an unhelpful term that hides the true issues concerning the mechanism of pain and subsequent therapies that patients with chronic radicular neuropathic pain are exposed to. Patients with chronic radicular neuropathic pain who have had previous spinal surgery are numerous and comparable in prevalence and incidence to other pain associated diseases such as rheumatoid arthritis but with higher annual costs. Better recognition of this patient group with the effective recognition and multi-disciplinary care aimed at achieving best patient and societal outcomes is required.
-
1. The group of patients with so-called 'failed back surgery syndrome' (FBSS) is very diverse. Published studies evaluating the outcome of surgical treatment vary widely in terms of surgical interventions that were performed. ⋯ The term 'failed back surgery syndrome' has been demonstrated to be an ill-defined term, serving as a container for all kinds of back and leg problems, and wrongly implying a definite role for the surgical intervention in the aetiology. We suggest shifting the paradigm to 'failed back syndrome'. With this term we suggest defining those patients with back and radicular leg pain without a structural deficit, or with a structural deficit that has a low a priori chance of benefiting from a surgical intervention.