syndrome (FBS) is defined as persistent or onset of low back or extremity pain
after spinal surgery. It has been
estimated that over 60% of individuals in pain clinics suffer from failed back
syndrome. There are numerous
causes for failed back syndrome, which include incomplete decompression,
recurrent or residual disc herniation, formation of the scar tissue, and
arachnoiditis. The course of
postoperative pain has to be determined by a comprehensive reevaluation, which
will require a thorough history, physical examination, possibly
electrodiagnostic studies, and in many cases advanced neurology studies such as
CT, myelogram, or MRI.
Postoperative MRI studies are typically performed with and without
contrast to help identify the presence of fibrosis or scar tissue. Re-evaluation after failed back
syndrome is often performed by a spine surgeon or a neurologist, who has
special experience and interest in this condition. It is often necessary to obtain a second or third opinion as
the condition can often be quite complex.
Failed back syndrome (FBS) refers to
chronic back and/or leg pain that occurs after back (spinal) surgery. Multiple
factors can contribute to the onset or development of FBS. Contributing factors
include but are not limited to residual or recurrent disc herniation,
persistent post-operative pressure on a spinal nerve, altered joint mobility,
joint hypermobility with instability, scar tissue (fibrosis), depression,
anxiety, sleeplessness and spinal muscular deconditioning. An individual may be predisposed to the
development of FBS due to systemic disorders such as diabetes, autoimmune
disease and peripheral blood vessels (vascular) disease. Smoking is a risk for
poor recovery from such an operation.
symptoms associated with FBS include diffuse, dull and aching pain involving
the back and/or legs. Abnormal sensibility may include sharp, pricking, and
stabbing pain in the extremities. Failed Back Syndrome should be evaluated and treated with an
interdisciplinary approach with a group of healthcare professionals from varied
fields working together toward a common goal for the patient. The therapeutic
approach to FBS may range from non-surgical to surgical intervention. The term post-laminectomy syndrome is used by some doctors to indicate the same
condition as failed back syndrome.