Failed Back Surgery Syndrome: Etiology, Diagnosis and Treatment
2 Clinic of Physical Medicine and Rehabilitation, İstanbul Physical Medicine and Rehabilitation Training and Research Hospital, İstanbul, Turkey
Failed back surgery syndrome (FBSS) describes a heterogeneous patient group with low back and/or leg pain who fail to have relief of pain after spinal surgery. The proper treatment of patients depends on a precise and accurate diagnosis. A complete history and physical examination, psychosocial evaluation should be performed and imaging studies be obtained. The underlying etiology can be categorised according to the clinical presentation, structural abnormality or onset of the symptoms after spinal surgery. The most common diagnosis are foraminal stenosis, painful disc, pseudoarthrosis, neuropathic pain, recurrent disc herniation, facet joint pain and sacroiliac joint pain respectively. The most useful imaging study in evaluating failed back surgery syndrome is magnetic resonance imaging. Pain management, rehabilitation or repeat surgery can be appropriate treatment options for selected patients. In this article the etiology, diagnosis and treatment of the failed back surgery syndrome are reviewed.
Keywords : Failed back surgery syndrome