Baber Zafeer, Erdek Michael A
Division of Pain Medicine, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
J Pain Res. 2016 Nov 7;9:979-987. doi: 10.2147/JPR.S92776. eCollection 2016.
The treatment of failed back surgery syndrome (FBSS) can be equally challenging to surgeons, pain specialists, and primary care providers alike. The onset of FBSS occurs when surgery fails to treat the patient's lumbar spinal pain. Minimizing the likelihood of FBSS is dependent on determining a clear etiology of the patient's pain, recognizing those who are at high risk, and exhausting conservative measures before deciding to go into a revision surgery. The workup of FBSS includes a thorough history and physical examination, diagnostic imaging, and procedures. After determining the cause of FBSS, a multidisciplinary approach is preferred. This includes pharmacologic management of pain, physical therapy, and behavioral modification and may include therapeutic procedures such as injections, radiofrequency ablation, lysis of adhesions, spinal cord stimulation, and even reoperations.
失败的脊柱手术综合征（FBSS）的治疗对外科医生、疼痛专家和初级保健提供者来说同样具有挑战性。当手术未能治疗患者的腰椎疼痛时，FBSS就会出现。将FBSS的可能性降至最低取决于确定患者疼痛的明确病因、识别高危人群，并在决定进行翻修手术之前用尽保守措施。FBSS的检查包括全面的病史和体格检查、诊断性影像学检查及相关操作。确定FBSS的病因后，多学科方法是首选。这包括疼痛的药物治疗、物理治疗和行为矫正，可能还包括注射、射频消融、粘连松解、脊髓刺激甚至再次手术等治疗手段。
