Failed back syndrome

Failed back syndrome (FBS), also called "failed back surgery syndrome" (FBSS), refers to chronic back and/or leg pain that occurs after back (spinal) surgery. Causes Complications that arise from back surgery or the natural healing process that follows back surgery. Risk Factors Multiple factors can contribute to the onset or development of FBS. Contributing factors include but are not limited to residual or recurrent disc herniation, persistent post-operative pressure on a spinal nerve, altered joint mobility, joint hypermobility with instability, scar tissue (fibrosis), depression, anxiety, sleeplessness and spinal muscular deconditioning. An individual may be predisposed to the development of FBS due to systemic disorders such as diabetes, autoimmune disease and peripheral blood vessels (vascular) disease. Smoking is a risk for poor recovery. Symptoms Common symptoms associated with FBS include diffuse, dull and aching pain involving the back and/or legs. Abnormal sensibility include sharp, pricking, and stabbing pain in the extremities. Diagnosis Failed back syndrome is an imprecise term encompassing a heterogeneous group of disorders that have in common pain symptoms after lumbar surgery. The most common diagnoses identified were spinal stenosis, internal disc disruption syndrome, recurrent/retained disc, and neural fibrosis. Treatment The treatments of FBS include physical therapy, minor nerve blocks, transcutaneous electrical nerve stimulation (TENS), behavioral medicine, non-steroidal anti-inflammatory (NSAID) medications, membrane stabilizers, antidepressants, spinal cord stimulation, and intracathecal morphine pump.