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Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation
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[Multimodal therapy concepts for failed back surgery syndrome].

Hans-Raimund Casser1

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Failed back surgery syndrome (FBSS) is a common complication of lumbar surgery. Non-operative, multimodal pain treatment is recommended when surgery is not indicated, focusing on interdisciplinary assessment and therapy.

Keywords:
Back acheDisk prolapseFailed back surgery syndromeMultimodal treatmentPain, chronic

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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.