Prevalence, characteristics, and burden of failed back surgery syndrome: the influence of various residual symptoms on patient satisfaction and quality of life as assessed by a nationwide Internet survey in Japan

Abstract

We conducted a cross-sectional, Internet-based survey with a nationally representative sample of Japanese adults to assess the prevalence and characteristics of failed back surgery syndrome (FBSS). Data regarding the residual symptoms and patient satisfaction from an online survey of 1842 lumbar surgery patients revealed the prevalence of FBSS to be 20.6% (95% confidence interval [CI], 18.8–22.6). The prevalence of low back pain, dull ache, numbness, cold sensations, and paresthesia after surgery was 94.0%, 71.1%, 69.8%, 43.3%, and 35.3%, respectively. With a logistic regression model, severe residual low back pain (numerical rating scale 8–10), higher pain intensity, and multiple low back surgeries were strongly associated with FBSS, with odds ratios of 15.21 (95% CI, 7.79–29.7), 1.40 (95% CI, 1.32–1.49), and 1.87 (95% CI, 1.25–2.81), respectively. Respondents with FBSS had significantly lower EuroQol-5D (P<0.001) values and significantly higher scores on the Kessler six-item psychological distress scale (P<0.001), compared with the non-FBSS group. Our findings indicate that residual sensations have a significant effect on patient quality of life, similar to that of chronic low back pain. Precise presurgical provision of prognoses based on comprehensive epidemiologic data, as well as scrupulous attention to patient satisfaction and clinical progress may help reduce the incidence of FBSS.

Minimally Invasive Transforaminal Lumbar Interbody Fusion for the Surgical Management of Post-Discectomy Syndrome

“…All patients attained radiological fusion at 12 months with 18 (60%) meeting the Ray's criteria of bony healing at 6-month follow-up (Figs. [3][4][5].…”

“…Early failure is generally due to poor patient selection, improper procedure, or infection (discitis). A new onset of pain following good surgical results may be due to recurrent disc herniation, instability of the operated segment, or affection at a different disc level [2,3].…”

The incidence and healthcare costs of persistent postoperative pain following lumbar spine surgery in the UK: a cohort study using the Clinical Practice Research Datalink (CPRD) and Hospital Episode Statistics (HES)

“…Using internet-based survey data, the authors found that among 1842 respondents who self-reported having undergone lumbar surgery in the past 10 years, 20.6% experienced ongoing pain. 29 strengths and limitations of this study This study used routinely captured hospital and primary care data to investigate diagnoses and treatment patterns on a population sample of lumbar surgery patients. Hence, our observations are based on patterns of care for a large and representative group of patients undergoing treatment in real-world settings.…”

The Added Value of High Dose Spinal Cord Stimulation in Patients with Failed Back Surgery Syndrome after Conversion from Standard Spinal Cord Stimulation

“…Failed Back Surgery Syndrome (FBSS) is characterized by persisting back and/or leg pain of unknown origin either persisting despite surgical intervention or appearing after surgical intervention for spinal pain [ 1 ]. FBSS affects between 10 and 40% of patients following back surgery, resulting in more pain, increased opioid use, disability, and lower quality of life [ 2 , 3 ]. In comparison to other common chronic pain and medical conditions, the impact of FBSS on an individual’s health-related quality of life (HRQoL) and its socio-economic burden are considerably higher [ 4 , 5 ].…”