Failed back syndrome: Difference between revisions
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==Overview== | ==Overview== | ||
'''Failed back syndrome''' or '''post-[[laminectomy]] syndrome''' is a condition characterized by persistent [[Pain and nociception|pain]] following [[laminectomy|back surgeries]]. | |||
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.<ref>{{cite journal |author=Long DM |title=Failed back surgery syndrome |journal=Neurosurg Clin N Am. |volume=2 |issue=4 |pages=899–919 |year=1991 |month=Oct |pmid=1840393 }}</ref><ref>{{cite journal |author=Fritsch EW, Heisel J, Rupp S |title=The failed back surgery syndrome: reasons, intraoperative findings, and long-term results: a report of 182 operative treatments |journal=Spine |volume=21 |issue=5 |pages=626–33 |year=1996 |month=Mar |pmid=8852320 |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0362-2436&volume=21&issue=5&spage=626 |doi=10.1097/00007632-199603010-00017}}</ref> It is characterized as a [[chronic pain]] syndrome. 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, [[hypermobility|joint hypermobility]] with instability, scar tissue ([[fibrosis]]), [[depression (mood)|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 vascular disease|peripheral blood vessels (vascular) disease]]. Smoking is a risk for poor recovery. | |||
Common symptoms associated with FBS include diffuse, dull and aching pain involving the back and/or legs. Abnormal sensibility may include sharp, pricking, and stabbing pain in the extremities. The term “post-laminectomy syndrome” is used by some doctors to indicate the same condition as failed back syndrome. | |||
The treatments of post-laminectomy syndrome include physical therapy, minor nerve blocks, [[TENS|transcutaneous electrical nerve stimulation]] (TENS), [[behavioral medicine]], [[Non-steroidal anti-inflammatory drug|non-steroidal anti-inflammatory]] (NSAID) medications, membrane stabilizers, [[antidepressants]], [[spinal cord stimulation]], and intracathecal morphine pump. Use of epidural steroid injections may be minimally helpful in some cases. The targeted anatomic use of a potent anti-inflammatory anti-TNF therapeutics is being investigated. | |||
The amount of spinal surgery varies around the world. The most is performed in the United States and Holland. The least in the United Kingdom and Sweden. Recently, there have been calls for more aggressive surgical treatment in Europe (see infra). Success rates of spinal surgery vary for many reasons. <ref>{{cite journal |author=Slipman CW, Shin CH, Patel RK, ''et al'' |title=Etiologies of failed back surgery syndrome |journal=Pain Med |volume=3 |issue=3 |pages=200–14; discussion 214–7 |year=2002 |month=Sep |pmid=15099254 |doi=10.1046/j.1526-4637.2002.02033.x }}</ref> <ref>{{cite journal |author=Taylor VM, Deyo RA, Cherkin DC, Kreuter W |title=Low back pain hospitalization. Recent United States trends and regional variations |journal=Spine |volume=19 |issue=11 |pages=1207–12; discussion 13 |year=1994 |month=Jun |pmid=8073311 }}</ref> | |||
Revision as of 07:17, 25 January 2009
| Failed back syndrome |
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Overview
Failed back syndrome or post-laminectomy syndrome is a condition characterized by persistent pain following back surgeries.
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.[1][2] It is characterized as a chronic pain syndrome. 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.
Common symptoms associated with FBS include diffuse, dull and aching pain involving the back and/or legs. Abnormal sensibility may include sharp, pricking, and stabbing pain in the extremities. The term “post-laminectomy syndrome” is used by some doctors to indicate the same condition as failed back syndrome.
The treatments of post-laminectomy syndrome 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. Use of epidural steroid injections may be minimally helpful in some cases. The targeted anatomic use of a potent anti-inflammatory anti-TNF therapeutics is being investigated.
The amount of spinal surgery varies around the world. The most is performed in the United States and Holland. The least in the United Kingdom and Sweden. Recently, there have been calls for more aggressive surgical treatment in Europe (see infra). Success rates of spinal surgery vary for many reasons. [3] [4]
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- ↑ Long DM (1991). "Failed back surgery syndrome". Neurosurg Clin N Am. 2 (4): 899–919. PMID 1840393. Unknown parameter
|month=ignored (help) - ↑ Fritsch EW, Heisel J, Rupp S (1996). "The failed back surgery syndrome: reasons, intraoperative findings, and long-term results: a report of 182 operative treatments". Spine. 21 (5): 626–33. doi:10.1097/00007632-199603010-00017. PMID 8852320. Unknown parameter
|month=ignored (help) - ↑ Slipman CW, Shin CH, Patel RK; et al. (2002). "Etiologies of failed back surgery syndrome". Pain Med. 3 (3): 200–14, discussion 214–7. doi:10.1046/j.1526-4637.2002.02033.x. PMID 15099254. Unknown parameter
|month=ignored (help) - ↑ Taylor VM, Deyo RA, Cherkin DC, Kreuter W (1994). "Low back pain hospitalization. Recent United States trends and regional variations". Spine. 19 (11): 1207–12, discussion 13. PMID 8073311. Unknown parameter
|month=ignored (help)