Failed back syndrome

Failed back syndrome refers to persistent leg and/or lumbar back pain after a surgical procedure. The pathophysiology of this syndrome is complex, as often the operation was technically successful.

Terminology

Other names for failed back syndrome include failed back surgery syndrome, post-laminectomy syndrome, or post-surgical spine syndrome.

Pathology

Etiology

• recurrent or residual lumbar disc disease
• scar
• postoperative instability (at operative level or at non-operative level)
• instrumentation-related, e.g. nerve root irritation from pedicle screw
• wrong-level surgery
• lateral recess or central canal stenosis
• synovial cyst
• spinal dural arteriovenous fistula
• epidural abscess
• epidural hematoma
• infection
• arachnoiditis