[Neurostimulation in patients with chronic neuropathic pain in the so-called failed back surgery syndrome (world and the author's experience)].

The failed back surgery syndrome (FBSS) is defined as protracted or recurrent pain, mainly in the lower back and/or legs, even after previous anatomically successful spinal surgery. Treatment of such patients commonly involves difficulties since neither medical therapy nor repeated back surgery does not result in adequate pain relief. Spinal cord stimulation (SCS) is a minimally invasive procedure that allows physicians and patients to define the effect of therapy just before permanent implantation. Both trial stimulation and permanent implantation are fully reversible. Early treatment with SCS has been shown to be very effective in correctly selected FBSS patients and therefore this procedure should be preferred over back resurgery. Clinical studies have demonstrated that CSC provides a sustained, long-term, 50% or more pain relief in over 60% of the patients and makes it possible to reduce the use of analgesics and to improve quality of life and functional status, thus permit many patients to resume work. Many patients told about fair therapeutic effects and the occurrence of mild side effects. Thus, SCS is an accessible alternative to traditional therapy. It is the treatment of choice in drug-resistant FBSS patients where recurrent neuropathic pin persists after surgery and analgesics are no longer effective.