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Failed back syndrome

Failed back syndrome (FBS) or post-laminectomy syndrome is characterized by persistent pain following back surgeries. Also called failed back surgery syndrome, FBS refers to chronic back and/or leg pain that occurs after spine surgery.

Many factors can contribute to the onset of FBS, including recurrent disc herniation, persistent postoperative pressure on a spinal nerve, altered joint mobility, joint hypermobility with instability, scar tissue, depression, anxiety, sleeplessness and spinal muscular deconditioning. People with diabetes, autoimmune disease and peripheral vascular disease may be predisposed to failed back syndrome. The original cause of the pain may recur following surgery or there may be complications arising from the procedure itself.

Common Symptoms

  • Diffuse, dull and aching pain in the back and/or legs
  • Sharp, pricking and stabbing pain that may extend to the legs


Diagnosis

Diagnosis of failed back syndrome includes x-rays, MRI scans and CT scans that visualize the structures of the back to identify the source of the pain. Your pain medicine specialist may also use minimally invasive spine procedures, such as epidural injections of steroids or pain medication to isolate the source of the pain and provide pain relief so that you can begin physical therapy.

Treatments

Treatments for failed back syndrome include physical therapy, nerve blocks, transcutaneous electrical nerve stimulation (TENS), behavioral medicine, non-steroidal anti-inflammatory (NSAID) medications, membrane stabilizers, antidepressants, spinal cord stimulation and intrathecal morphine pump. Epidural steroid injections may be helpful in some cases.

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