Interdisciplinary treatment of failed back surgery syndrome (FBSS): a comparison of FBSS and non-FBSS patients

Many patients enrolled in chronic pain centers suffer from failed back surgery syndrome (FBSS). However, there has been a paucity of research concerning how these patients differ from other chronic pain patients, and how to most effectively address their complex problems within an interdisciplinary chronic pain treatment environment. The current study represents the first large-scale examination of these issues, with two major aims: (1) to elucidate the differences between FBSS patients and other chronic lumbar pain patients; and (2) to clarify the role of injections in interdisciplinary treatment, particularly with FBSS patients. A total of 128 chronic lumbar pain patients who presented for treatment at an interdisciplinary center were included in the study. Patients completed various measures at pre-, mid-, and post-treatment intervals, including physical, functional, and psychosocial measures. Overall, both FBSS and Non-FBSS patients reported significantly decreased pain and disability, and significant improvements in physical and psychosocial functioning after interdisciplinary treatment. However, Non-FBSS patients were associated with greater reductions in self-reported pain and disability than FBSS patients. On the other hand, FBSS patients were significantly more improved on physical therapy measures, including Activities of Daily Living, Strength, and Fear of Exercise. Statistical comparisons of Injection (INJ) and No-Injection (No-INJ) groups yielded few significant findings.