Failed back surgery syndrome: who has failed?

Area of Science:

• Pain Management
• Spine Surgery Outcomes
• Health Systems Research

Background:

• Failed back surgery syndrome (FBSS) is characterized by chronic back and radicular pain post-surgery.
• The term "failure" in FBSS carries negative connotations, impacting patient and therapist understanding.
• Clinician perceptions of FBSS vary significantly based on their medical background.

Purpose of the Study:

• To explore expert perspectives on defining and managing postoperative back and radicular pain.
• To address the challenges posed by the term "Failed Back Surgery Syndrome" (FBSS).
• To propose an optimized, patient-centered care pathway for FBSS.

Main Methods:

• Qualitative study involving eight health system experts from diverse specialties.
• Experts were consulted to define and share their specialist viewpoints on managing postoperative pain.
• Analysis focused on understanding varied perspectives to inform treatment strategies.

Main Results:

• Expert consensus highlighted the need to move beyond the "failure" narrative in FBSS.
• A multidisciplinary approach is crucial for comprehensive patient care.
• The current understanding and management of FBSS require a shift towards a more positive, future-oriented perspective.

Conclusions:

• The pejorative connotation of FBSS should be replaced with a temporal concept focusing on future care.
• Redefining the care pathway and renaming the syndrome can foster a more positive, patient-centered approach.
• Achieving consensus through consultation is key to optimizing management and patient outcomes.