Failed back surgery syndrome: what's in a name? A proposal to replace "FBSS" by "POPS"…

Area of Science:

• Spine Surgery
• Pain Management
• Patient Outcomes

Background:

• The current definition of Failed Back Surgery Syndrome (FBSS) carries negative connotations and lacks consensus.
• Evaluating FBSS patients requires a multidisciplinary approach, yet the definition remains controversial and varies.
• There is a need for a global consensus on the definition, diagnosis, and management of patients experiencing persistent issues after spine surgery.

Purpose of the Study:

• To propose a new term,
• PostOperative Persistent Syndrome (POPS)
• , to replace FBSS.
• To establish a consensus on a new definition that incorporates pain mechanisms, function, and psychosocial aspects.
• To guide future research and clinical practice for better patient outcomes.

Main Methods:

• Literature review and expert discussion on the definition and nomenclature of FBSS.
• Analysis of the limitations of the current FBSS definition.
• Proposal of a new acronym (POPS) and a framework for a consensus-based approach.

Main Results:

• The term FBSS is considered pejorative and restrictive.
• POPS is proposed as a more encompassing term for persistent pain, functional deficits, and psychosocial issues post-spine surgery.
• Distinguishing between
• true
• , and
• potential
• , FBSS patients is crucial for appropriate management.

Conclusions:

• Replacing FBSS with POPS can help shift focus from past failure to future management.
• Integrating pain mechanisms (nociceptive, neuropathic) into diagnosis is key.
• Developing a network and database for prospective data analysis can define outcome predictors for this patient population.