[Multimodal therapy concepts for failed back surgery syndrome].

Area of Science:

• Pain Medicine
• Neurosurgery
• Rehabilitation Medicine

Background:

• Failed back surgery syndrome (FBSS) is a frequent complication (15-40%) following lumbar disc surgery.
• Surgical re-intervention is rarely successful for FBSS, except in cases of re-prolapse with radicular pain.
• Multimodal pain treatment is indicated when pathoanatomical correlates are absent and psychosocial factors are present.

Purpose of the Study:

• To describe a standardized non-operative treatment protocol for Failed Back Surgery Syndrome.
• To outline the importance of interdisciplinary assessment in managing FBSS.
• To guide the application of multimodal pain therapy to prevent chronic pain development.

Main Methods:

• A comprehensive review of non-operative treatment strategies for FBSS.
• Emphasis on broad interdisciplinary clarification involving medical, psychological, and physiotherapeutic assessment.
• Application of the OPS 8-918 procedure when conditions for multimodal pain therapy are met.

Main Results:

• Standardized non-operative treatment initiated with interdisciplinary assessment is proposed.
• The OPS 8-918 procedure can be utilized to avert the development of chronic pain.
• Adherence to quality standards and guidelines for documentation is crucial.

Conclusions:

• Multimodal pain treatment is the recommended approach for FBSS when surgical options are limited.
• Interdisciplinary assessment is a key component of effective non-operative FBSS management.
• Timely application of multimodal therapy can prevent the chronification of pain after back surgery.