Selection of surgical procedures for treatment of failed back surgery syndrome (FBSS)

The paper presents the definition of failed back surgery syndrome (FBSS), current surgical treatment options and other pain control options. Available data indicates an occurrence rate of FBSS in 5-50% of cases. A steep increase of the number of performed spinal procedures has also led to an increase in the number of FBSS cases. FBSS is caused by a complex relation of different causes: biological, psychological. social and economic. Patient selection and correct indications are of key importance for successful surgical treatment of FBSS. The pathology to be addressed must be clearly defined in imaging studies, in order to perform the procedure that will yield optimal results. In over 50% with FBSS a psychological or behavioral dysfunction can be noted, and identification of such condition is part of FBSS prevention protocols. Surgical techniques for FBSS treatment include decompression, stabilization and fusion and dynamic neutralization procedures. These techniques are discussed in the paper.