Asian Spine J.  2017 Aug;11(4):642-652. 10.4184/asj.2017.11.4.642.

Neuropathic Pain after Spinal Surgery

• Cho JH
• Lee JH
• Song KS
• Hong JY

• KMID: 2387671
• DOI: http://doi.org/10.4184/asj.2017.11.4.642

Abstract

Neuropathic pain after spinal surgery, the so-called failed back surgery syndrome (FBSS), is a frequently observed troublesome disease entity. Although medications may be effective to some degree, many patients continue experiencing intolerable pain and functional disability. Only gabapentin has been proven effective in patients with FBSS. No relevant studies regarding manipulation or physiotherapy for FBSS have been published. Spinal cord stimulation (SCS) has been widely investigated as a treatment option for chronic neuropathic pain, including FBSS. SCS was generally accepted to improve chronic back and leg pain, physical function, and sleep quality. Although the cost effectiveness of SCS has been proved in many studies, its routine application is limited considering that it is invasive and is associated with safety issues. Percutaneous epidural adhesiolysis has also shown good clinical outcomes; however, its effects persisted for only a short period. Because none of the current methods provide absolute superiority in terms of clinical outcomes, a multidisciplinary approach is required to manage this complex disease. Further studies concerning the etiology, diagnosis, treatment, and cost effectiveness of FBSS are warranted to deepen our understanding of this condition.

Keyword

Neuralgia; Failed back surgery syndrome; Spinal cord stimulation; Percutaneous adhesiolysis

MeSH Terms

Cost-Benefit Analysis
Diagnosis
Failed Back Surgery Syndrome
Humans
Leg
Neuralgia*
Spinal Cord Stimulation