Failed back syndrome

Changed by Henry Knipe, 20 Sep 2015

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Failed back syndrome refers to persistent leg and/or lumbar back pain after a surgical procedure. The pathophysiology of this syndrome is complex, as often the operation was technically successful.

Terminology

Other names for failed back syndrome include failed back surgery syndrome, post-laminectomy syndrome, or post-surgical spine syndrome.

Pathology

Aetiology

recurrent or residual lumbar disc disease
scar
postoperative instability (at operative level or at non-operative level)
instrumentation-related, e.g. nerve root irritation from pedicle screw
wrong-level surgery
lateral recess or central canal stenosis
synovial cyst
spinal dural arteriovenous fistula
epidural abscess
epidural haematoma
infection
arachnoiditis

-<p><strong>Failed back syndrome</strong> refers to persistent leg and/or lumbar back pain after a surgical procedure. The pathophysiology of this syndrome is complex, as often the operation was technically successful. </p><h4>Terminology</h4><p>Other names for failed back syndrome include <strong>failed back surgery syndrome</strong>, <strong>post-laminectomy syndrome</strong>, or <strong>post-surgical spine syndrome</strong>.</p>
+<p><strong>Failed back syndrome</strong> refers to persistent leg and/or lumbar back pain after a surgical procedure. The pathophysiology of this syndrome is complex, as often the operation was technically successful. </p><h4>Terminology</h4><p>Other names for failed back syndrome include <strong>failed back surgery syndrome</strong>, <strong>post-laminectomy syndrome</strong>, or <strong>post-surgical spine syndrome</strong>.</p><h4>Pathology</h4><h5>Aetiology</h5><ul>
+<li>recurrent or residual <a href="/articles/lumbar-disc-disease">lumbar disc disease</a>
+</li>
+<li>scar</li>
+<li>postoperative instability (at operative level or at non-operative level)</li>
+<li>instrumentation-related, e.g. nerve root irritation from pedicle screw</li>
+<li>wrong-level surgery</li>
+<li>lateral recess or central canal stenosis</li>
+<li><a href="/articles/spinal-synovial-cyst-1">synovial cyst</a></li>
+<li><a title="Spinal dural arteriovenous fistula" href="/articles/spinal-dural-arteriovenous-fistula">spinal dural arteriovenous fistula</a></li>
+<li><a href="/articles/spinal-epidural-abscess">epidural abscess</a></li>
+<li><a href="/articles/spinal-epidural-haematoma">epidural haematoma</a></li>
+<li>infection</li>
+<li><a href="/articles/arachnoiditis">arachnoiditis</a></li>
+</ul>

References changed:

1. Arts MP, Jacobs WCH, Peul WC. Failed back (surgery) syndrome: Time for a paradigm shift. British Journal of Pain February 2013 vol. 7 no. 1 48-55. Available from: http://bjp.sagepub.com/content/7/1/48.full
2. Ordia J, Vaisman J. Post-surgical spine syndrome. Surg Neurol Int. 2011;2 (1): 132. <a href="http://dx.doi.org/10.4103/2152-7806.85475">doi:10.4103/2152-7806.85475</a> - <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3205485">Free text at pubmed</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/22059127">Pubmed citation</a><span class="auto"></span>
3. Young PM, Berquist TH, Bancroft LW et-al. Complications of spinal instrumentation. Radiographics. 2007;27 (3): 775-89. <a href="http://radiographics.rsna.org/content/27/3/775.full">Radiographics (full text)</a> - <a href="http://dx.doi.org/10.1148/rg.273065055">doi:10.1148/rg.273065055</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/17495292">Pubmed citation</a><span class="ref_v3"></span>

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