Etymological and Clinical Debate Over the Phrase Failed Back Surgery Syndrome (FBSS): Proposal of A Substitutive Term Previously Operate Back Syndrome (POBS)

Abstract

There are so many definitions about failed back surgery syndrome as persistent back and/or leg pain despite having completed spinal surgery. But when we proclaim that surgery is finished and how we know that something new doesn’t occur that by itself need special attention and treatment. In our center we observe many cases assume of failed back surgery syndrome to manage. We learnt that majority of this cases can be treated and getting good result with meticulous thorough work up to clarifying their undergoing pathophysiology. In this perspective there should be another definition for failed back surgery syndrome this definition should be only allocated to those patients that after full evaluation we cannot find any anatomopathologcal reason to explain their ailment scenario, in other words we have here a chronic pain syndrome case when we say FBSS. We seek an important goal by stressing in lexical debate on the term FBSS and the goal is to emphasize on planning an exhaustive evaluation of any patient with previous surgery on his or her back. Many of these patients has stenosis, recurrent herniated nucleus pulposus (HNP), pseudarthrosis, new instability, adjacent level disease and so many like that. All of this are surgically curable sufferings and we haven’t yet failed. After correcting those pathoanatomy we have small group of patients with really chronic pain disease that they also not failed back surgery cases they are the patients who need multimodal treatment option which exactly every  pain specialist is thoroughly acquainted with. As lumbar surgery continues to grow in prevalence, so will the number patients suffering from FBSS. It is important for physicians treating this population to expand their knowledge of FBSS etiologies and appropriate diagnostic imaging modalities, combined with confirmatory diagnostic injections, and proper technique for interventional pain procedures. Therefore we propose to substitute the term FBSS with previously operated  back syndrome which in addition to expunge the negative meaning of failure for the surgeon and patients it denote the different clinical situation of this patients which need special evaluation and treatment algorhythm.

 Keywords: Failed Back Surgery Syndrome (FBSS); Previously Operate Back Syndrome (POBS)