Persistence of pain after spine surgery has been called by different names such as failed back surgery syndrome, postlaminectomy syndrome or simply failed back syndrome. It does not represent failure of surgery; it represents a cluster of syndromes following spine surgery wherein the expectations of the patient and surgeon are not met. Pain may persist, increase, may change its character and may spread to a new area. Persistent pain following spine surgery is common after discectomy, laminectomy, decompression, spinal fusions and minimally invasive surgical treatment.
Among these etiologies epidural fibrosis (20% to 36%), facet joint dysfunction (8% to 16%), sacroiliac joint dysfunction (upto 35% in spinal fusion surgeries), internal disc disruption, recurrent disc herniation, and spinal stenosis are very common and can be treated by interventional pain management procedures. Among the various interventional pain management procedures based on probable etiologies, the following are commonly done :
But in many cases all these procedures may prove unsuccessful for long-term relief and spinal cord stimulation may prove beneficial and cost effective in the long run.
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