Principles & Practice of Pain Medicine > Part IV. Pain by Anatomic Location > B. Spine > Chapter 30. Failed Back Surgery Syndrome Ranjan Dey and Thomas T. Simopoulos

Definition

"Failed back surgery syndrome (FBSS) was defined by North and Campbell in 1991 as persistent or recurring low back pain, with or without sciatica, following one or more lumbar spine operations.¹ Van Goethem and colleagues describe it as a syndrome characterized by intractable pain and various degrees of functional incapacitation, following spine surgery.² Rowlingson uses the term failed back surgery syndrome for patients with chronic debilitating low back pain occurring in a patient after back surgery of a variety of types, such as discectomy, laminectomy, and lumbosacral fusion, that was unsuccessful in relieving the patient's symptoms.³ Fiume and colleagues consider FBSS to be a severe, long-lasting, disabling, and relatively frequent (5%–10%) complication of lumbosacral spine surgery.⁴ Although disability and chronic pain are commonly seen in the lumbosacral region and the lower extremity, similar mechanisms, pathophysiology, diagnostic dilemmas, and management options can be seen and extrapolated to the cervicothoracic region and the upper extremity...."