Failed back surgery syndrome: review and new hypotheses

Area of Science:

• Spine Surgery
• Pain Management
• Diaphragm Physiology

Background:

• Failed back surgery syndrome (FBSS) is characterized by persistent lumbosacral pain post-spinal surgery.
• Etiologies include pre-existing conditions, surgical errors, and post-operative complications like infections or biomechanical changes.

Purpose of the Study:

• To review current literature on FBSS.
• To propose a novel hypothesis for FBSS causes.
• To investigate the role of diaphragm dysfunction in FBSS.

Main Methods:

• Comprehensive literature review on failed back surgery syndrome.
• Analysis of potential risk factors across pre-operative, intra-operative, and post-operative phases.
• Exploration of diaphragm muscle function in relation to chronic pain.

Main Results:

• Existing literature identifies various causes of FBSS.
• Diaphragm muscle dysfunction is a previously unconsidered factor in FBSS.
• The diaphragm plays a role in chronic lower back and sacroiliac pain perception.

Conclusions:

• FBSS has multifactorial causes.
• Diaphragm dysfunction presents a new avenue for understanding and potentially treating FBSS.
• Further research is needed to validate the diaphragm's role in pain management for FBSS patients.