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Related Experiment Video

Updated: Mar 31, 2026

Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation
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Failed back (surgery) syndrome: time for a paradigm shift.

Carmen Lam Vleggeert-Lankamp1, Mark P Arts2, Wilco Ch Jacobs1

  • 1Department of Neurosurgery, Leiden University Medical Centre (LUMC), Leiden, the Netherlands.

British Journal of Pain
|October 31, 2015
PubMed
Summary
This summary is machine-generated.

The term "failed back surgery syndrome" is poorly defined and often misattributed to surgery. A new term, "failed back syndrome," is proposed for patients with persistent pain without a clear surgical solution.

Keywords:
Failed backlow back surgerylumbar spondylodesisrevision low back surgeryspine surgery

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Area of Science:

  • Neurosurgery
  • Orthopedics
  • Pain Management

Background:

  • The term 'failed back surgery syndrome' (FBSS) is applied to diverse patient groups with persistent complaints after spinal surgery.
  • Existing literature on surgical outcomes for FBSS is highly variable and results are not generalizable.
  • The causative role of surgery in FBSS is often implied but lacks strong evidence.

Purpose of the Study:

  • To critically evaluate the current understanding and definition of failed back surgery syndrome.
  • To propose a revised terminology and diagnostic framework for patients with persistent spinal pain post-surgery.
  • To highlight the need for realistic patient expectations and improved preoperative assessment.

Main Methods:

  • Comprehensive literature review of studies on surgical outcomes and patient recovery in FBSS.
  • Analysis of randomized controlled trials and assessment of study bias.
  • Critical evaluation of the etiological implications of the term 'failed back surgery syndrome'.

Main Results:

  • Studies with acceptable bias assessment show low to moderate patient-perceived recovery.
  • A single randomized controlled trial found no difference between fusion surgery and conservative management.
  • Current evidence does not support repeat surgery for FBSS, though select cases may benefit; predictors of success are not identified.

Conclusions:

  • The term 'failed back surgery syndrome' is an ill-defined concept that wrongly attributes causality to surgery.
  • A shift in terminology to 'failed back syndrome' is suggested to better describe patients with persistent pain without a clear surgical indication.
  • Preoperative psychological assessment and patient education are crucial for managing expectations and predicting surgical outcomes.