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J Am Acad Orthop Surg, Vol 14, No 9, September 2006, 534-543.
© 2006 the American Academy of Orthopaedic Surgeons
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Failed Back Surgery Syndrome: Diagnostic Evaluation

Richard D. Guyer, MD, Michael Patterson, MD and Donna D. Ohnmeiss, DrMed

Dr. Guyer is President, Texas Back Institute, and Co-Director, Spine Surgery Fellowship Program, Texas Back Institute, Plano, TX. Dr. Patterson is Spine Surgeon, Southern Bone and Joint Specialists, Hattiesburg, MS. Dr. Ohnmeiss is President, Texas Back Institute Research Foundation, Texas Back Institute.

None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Guyer, Dr. Patterson, and Dr. Ohnmeiss.

Reprint requests: Dr. Guyer, Texas Back Institute, 6020 West Parker Road, Suite 200, Plano, TX 75093.

Failed back surgery syndrome is a common problem with enormous costs to patients, insurers, and society. The etiology of failed back surgery can be poor patient selection, incorrect diagnosis, suboptimal selection of surgery, poor technique, failure to achieve surgical goals, and/or recurrent pathology. Successful intervention in this difficult patient population requires a detailed history, precise physical examination, and carefully chosen diagnostic tests. The diagnostic evaluation should endeavor to accurately identify symptoms, rule out extraspinal causes, identify a specific spinal etiology, and assess the psychological state of the patient. Only after these factors have been assessed can further treatment be planned.






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Copyright © 2006 by the American Academy of Orthopaedic Surgeons.