Failed Back Surgery Syndrome: No Longer a Surgeon’s Defeat—A Narrative Review

Abstract

The introduction of the term Persistent Spinal Pain Syndrome (PSPS-T1/2), replacing the older term Failed Back Surgery Syndrome (FBSS), has significantly influenced our approach to diagnosing and treating post-surgical spinal pain. This comprehensive review discusses this change and its effects on patient care. Various diagnostic methods are employed to elucidate the underlying causes of back pain, and this information is critical in guiding treatment decisions. The management of PSPS-T1/2 involves both causative treatments, which directly address the root cause of pain, and symptomatic treatments, which focus on managing the symptoms of pain and improving overall function. The importance of a multidisciplinary and holistic approach is emphasized in the treatment of PSPS-T1/2. This approach is patient-centered and treatment plans are customized to individual patient needs and circumstances. The review concludes with a reflection on the impact of the new PSPS nomenclature on the perception and management of post-surgical spinal pain.

The Subjective and Objective Improvement Using Chiropractic Biophysics® Protocols

“…Despite these invasive interventions, the PROs were not improved until she received non-surgical spinal rehabilitation with CBP® methods. Very recent research and nomenclature studies recognize FBSS and adult spine deformity (ASD) as a new category of persistent spine pain syndrome (PSPS-T1/T2) [30]. The importance of multidisciplinary and a holistic approach is suggested in the treatment of PSPS-T1/12, and CBP® methods may be a good match to address this need as described in the present case.…”

“…3-12 months) [7]. If the HRQoL and the sagittal and coronal balance are not improved and/or there is hardware failure, infection, or vascular abnormalities due to the surgery, a diagnosis of FBSS/PSPS is requisite [30]. Poor low back spine surgical outcomes are treated with many conservative drug therapies including nonsteroidal anti-inflammatories and over-the-counter pain relievers as well as prescription opioids and steroids, and physical therapies [2,3,5,[27][28][29].…”

Multimodal management strategies for chronic pain after spinal surgery: a comprehensive review

“…Identifying and resolving yellow flags can guide appropriate referrals for psychological support and help manage overall pain. The typical red and yellow flags reported for CPSS are listed in Table 2 [ 28 ].…”