Abstract
Failed Back surgery syndrome or persistent low back pain following lumbar surgery is a known complication of lumbosacral spine surgery. The incidence of FBSS ranges from 5% to 10% postlumbosacral surgery. It is characterized by disabling pain resistant to usual analgesic and physiotherapy. Epidural fibrosis is found to be the most common cause of FBSS. Various treatment modalities such as spinal canal stimulation, epidural corticosteroids injection, Non steriodal antiinflammatory drugs, opioids, and repeat surgery have been tried for the management of FBSS, but none of them have shown a promising result. The second surgery in such patients has a poor success rate of only 30%–35%. 15%–20% patients even reported worsening of symptoms after a second surgery. Gabapentin which is an analog of gamma-aminobutyric acid has shown good results in few studies in reducing pain in patients with failed back surgery syndrome FBSS. Few case reports and randomized control trials published in recent past has shown good efficacy of gabapentin in reducing low back pain as well as leg pain associated with failed back surgery syndrome FBSS. To conclude, gabapentin can be tried in a patient with FBSS, but its efficacy needs to be established with a large multicentric study.
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