Related Experiment Videos
Failed back surgery: etiology and diagnostic evaluation
Jerome Schofferman1, James Reynolds, Richard Herzog
1San Francisco Spine Institute-SpineCare Medical Group, 1850 Sullivan Avenue, Daly City, CA 94014, USA. jschoff@ix.netcom.com
Summary
Accurate diagnosis of failed back surgery syndrome (FBSS) is crucial for effective treatment. A comprehensive approach including history, imaging, psychological evaluation, and diagnostic injections achieves over 90% diagnostic accuracy for FBSS.
Area of Science:
- Spine surgery
- Pain management
- Diagnostic imaging
Background:
- Synopsis of a 2002 North American Spine Society Annual Meeting symposium.
- Focuses on the diagnosis of failed back surgery syndrome (FBSS).
Framework:
- Emphasizes precise diagnosis as key to successful FBSS treatment.
- Utilizes a multi-faceted diagnostic approach.
Implementation:
- Combines patient history, physical examination, imaging studies, psychological evaluation, and diagnostic injections.
- Achieves diagnostic accuracy in over 90% of FBSS cases.
- Identifies common causes: foraminal stenosis, painful disc, pseudarthrosis, neuropathic pain, recurrent disc herniation, facet joint pain, and sacroiliac joint pain.
Implications:
- Highlights the importance of recognizing psychological factors in FBSS.
- Diagnostic injections are valuable for specific pain sources (facet, SIJ, discogenic).
- Spine surgeons need awareness of common FBSS causes for thorough patient evaluation and problem minimization.