A Al Kaisy1, D Pang1, M J Desai2, P Pries3, R North4, R S Taylor5, L Mc Cracken6, P Rigoard7. 1. Pain Management Department, St Thomas & Guy's Hospital, London, UK. 2. International Spine, Pain & Performance Center, Washington DC 20009, USA. 3. Spine and Neuromodulation Functional Unit, Poitiers University Hospital, 86000 Poitiers, France. 4. Department of neurosurgery, Johns Hopkins University, School of Medicine, Baltimore, MD, USA. 5. Institute of Health Research, University of Exeter Medical School, Exeter, UK. 6. Department of Psychology & Behavioural Medicine, King's College, London, UK. 7. Spine and Neuromodulation Functional Unit, Poitiers University Hospital, 86000 Poitiers, France; N(3)Lab (Neuromodulation & Neural Networks), Poitiers University Hospital, 86000 Poitiers, France. Electronic address: philipperigoard@yahoo.fr.
Abstract
INTRODUCTION: Failed back surgery syndrome (FBSS) results from a cascade of medical and surgical events that lead to or leave the patient with chronic back and radicular pain. This concept is extremely difficult to understand, both for the patient and for the therapist. The difficulty is related to the connotations of failure and blame directly associated with this term. The perception of the medical situation varies enormously according to the background and medical education of the clinician who manages this type of patient. Eight health system experts (2 pain physicians, 1 orthopaedic spine surgeon, 1 neuro spine surgeon, 1 functional neurosurgeon, 1 physiatrist, 1 psychologist and one health-economic expert) were asked to define and share their specialist point of view concerning the management of postoperative back and radicular pain. Ideally, it could be proposed that the patient would derive optimal benefit from systematic confrontation of these various points of view in order to propose the best treatment option at a given point in time to achieve the best possible care pathway. CONCLUSION: The initial pejorative connotation of FBSS suggesting failure or blame must now be replaced to direct the patient and therapists towards a temporal concept focusing on the future rather than the past. In addition to the redefinition of an optimised care pathway, a consensus based on consultation would allow redefinition and renaming of this syndrome in order to ensure a more positive approach centered on the patient.
INTRODUCTION: Failed back surgery syndrome (FBSS) results from a cascade of medical and surgical events that lead to or leave the patient with chronic back and radicular pain. This concept is extremely difficult to understand, both for the patient and for the therapist. The difficulty is related to the connotations of failure and blame directly associated with this term. The perception of the medical situation varies enormously according to the background and medical education of the clinician who manages this type of patient. Eight health system experts (2 pain physicians, 1 orthopaedic spine surgeon, 1 neuro spine surgeon, 1 functional neurosurgeon, 1 physiatrist, 1 psychologist and one health-economic expert) were asked to define and share their specialist point of view concerning the management of postoperative back and radicular pain. Ideally, it could be proposed that the patient would derive optimal benefit from systematic confrontation of these various points of view in order to propose the best treatment option at a given point in time to achieve the best possible care pathway. CONCLUSION: The initial pejorative connotation of FBSS suggesting failure or blame must now be replaced to direct the patient and therapists towards a temporal concept focusing on the future rather than the past. In addition to the redefinition of an optimised care pathway, a consensus based on consultation would allow redefinition and renaming of this syndrome in order to ensure a more positive approach centered on the patient.
Authors: Ji Yeong Kim; Do-Hyeong Kim; Dong Woo Han; Young Chan Kim; Ji Young Lee; Young Kyung Park; Hue Jung Park Journal: Int J Med Sci Date: 2022-06-06 Impact factor: 3.642
Authors: Kliment Gatzinsky; Sam Eldabe; Jean-Philippe Deneuville; Wim Duyvendak; Nicolas Naiditch; Jean-Pierre Van Buyten; Philippe Rigoard Journal: Pain Res Manag Date: 2019-07-08 Impact factor: 3.037
Authors: Nick Christelis; Brian Simpson; Marc Russo; Michael Stanton-Hicks; Giancarlo Barolat; Simon Thomson; Stephan Schug; Ralf Baron; Eric Buchser; Daniel B Carr; Timothy R Deer; Ivano Dones; Sam Eldabe; Rollin Gallagher; Frank Huygen; David Kloth; Robert Levy; Richard North; Christophe Perruchoud; Erika Petersen; Philippe Rigoard; Konstantin Slavin; Dennis Turk; Todd Wetzel; John Loeser Journal: Pain Med Date: 2021-04-20 Impact factor: 3.750