FAILED BACK SURGERY SYNDROME (FBSS)

Abstract

Failed Back Surgery Syndrome (FBSS) is a serious health problem and a term used to describe persistent or recurrent pain (limited or radiating to the lower limbs) of the lower back, occurring after one or more surgeries. According to various sources, it affects 10-44% of operated patients and, due to the constantly growing number of spine surgeries, it shows an upward trend. The etiology of FBSS can be surgical and non-surgical, but the mechanism of pain is complex. The most common causes include: intervertebral foramen stenosis, discogenic pain, pseudoarthrosis, and recurrent disc prolapse syndrome. The pain is neuropathic in nature with allodynia, hyperalgesia and dysesthesia. The aim of this work: FBSS in therapy is perceived as a huge challenge for both surgeons and other physicians, because due to the numerous causes and complex pathomechanism of pain, pain syndromes after unsuccessful spine surgeries often turn out to be resistant to treatment. As a result, it is important for a clinician to understand the problem and initiate appropriate treatment for a patient struggling with this syndrome. Methods: Selected articles from the Pubmed database and specialized literature were analyzed in detail. We focused on the characteristics of the pain occurring in this syndrome, its diagnosis and treatment. Conclusion: FBSS has various etiologies. Factors predisposing to the occurrence of chronic pain can be divided into preoperative, intraoperative and postoperative. Pain assessment is an important point in the decision-making process regarding management and treatment, which should be individual. The use of imaging tests is irreplaceable in diagnostics.